IGH - CNY-246 - June 20

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CNYHEALTH.COM

JUNE 2020 • ISSUE 246

Patients Wanted Drastic reduction in patient population, layoffs, limited sources of revenue. How hospitals are managing one of the worst crises in the industry and what they are doing to recover from it. Page. 17

Tired of COVID-19? Here’s one more thing to worry about this summer: disease-carrying ticks Jai Singh, a general surgeon in Oswego, discusses how the pandemic has changed the way he practices

Fitness in the Finger Lakes Forget COVID-19. New free hiking challenge offers incentives for people to get active on the trails this summer. P. 20

Why You Should Eat Snapper This Summer P. 15

Baby Boom After Pandemic Lockdowns?

P. 2

Baby Boom After Pandemic Lockdowns?

Maybe Not

I

t’s happened before: Couples stuck at home during blizzards, hurricanes or other natural disasters enjoy some “alone time” — and a baby boom follows.

But a new survey from researchers at the University of Florence in Italy suggests the same probably won’t unfold during the COVID-19 pandemic.

Why? “What we found the main rea-

sons that led people to not wanting to conceive included worries related to future economic difficulties and consequences on pregnancy,” said study author Elisabetta Micelli, from the university’s Assisted Reproduction Technologies Center.

The researchers conducted nearly 1,500 online interviews and found that nearly 82% of those surveyed said they didn’t plan to conceive during the coronavirus pandemic.

The survey was conducted in the third week of the lockdown in Italy and included men and women in a stable heterosexual relationship for at least one year.

The findings were published May 7 in the Journal of Psychosomatic Obstetrics and Gynecology.

Of the 268 participants who said that, prior to the pandemic, they had plans to have a child, more than one-third abandoned their intentions

when the pandemic struck. The main reasons were worries about future economic struggles (58%) and any potential consequences on pregnancy (58%) from the new coronavirus.

Even though almost half of those who responded to the survey had not lost their jobs or income, “the fear of imminent and future economic instabilities led those who were searching for a pregnancy to stop their intention in 58% of cases,” Micelli said in a journal news release.

Interestingly, 140 (11.5%) of the participants — mostly women — expressed a new desire for parenthood during quarantine, with the main reasons being “the will for change” (50%) and “the need for positivity” (40%).

But only six of the 140 (4.3%) actually tried to get pregnant during the lockdown.

“Again, fear of consequences on pregnancy in addition to the economic impact on families are probably the reasons why almost the whole group of couples who unexpectedly started to express a desire for parenthood during quarantine did not translate this dream into a concrete attempt,” said study co-author Gianmartin Cito, a specialist training in urology.

The study also asked participants about their levels of sexual activity and found that two-thirds of those who didn’t express a wish to conceive before or during the pandemic reported no decrease in sex.

The same was true for 60% of people already trying to conceive.

It’s “unknown whether these findings will result in a substantial modification of birth rate in the near future,” the authors concluded.

Here for CNY. As always.

Faster Treatment = Better Outcomes People have been avoiding emergency rooms fearing they will be exposed to the COVID-19 virus.

Getting to the hospital quickly is critical for patients suffering heart attacks or strokes, when heart and brain cells can die by the minute. Other serious conditions — such as severe headache or stomach ache — can also cause long-lasting damage if treatment is delayed.

Our regionally recognized emergency services, cardiac care and Comprehensive Stroke Center teams are here 24/7 to provide you and your family with rapid intervention and treatment for all medical emergencies.

Your Safety = Top Priority To keep you safe, we have put in place stringent safety and infection control measures in our Pomeroy Emergency Services Department and across our entire hospital and outpatient sites to prevent the spread of infection, including:

Screening patients, visitors and staff at entry points Requiring all patients, visitors and staff to wear a mask Isolating suspected COVID-19 patients in private rooms Rigorous deep cleaning/disinfecting of all surface areas

Don’t wait to go to the Emergency Department – Call 911 #TakeMeToCrouse Page 2

•

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

Discover howVenturing Out? Guard Yourself Discover howAccountant says goodbye painful pounds, says, “hello size 2!”

Against Disease-Carrying Ticks Accountant says goodbye to to4747painful pounds, says, “hello size 2!”

The latest? Asian long-horned tick is expanding its range and has moved into New York state, says expert

A

s pandemic-related restrictions ease and people return to parks and other outdoor spaces, remember to protect yourself against another threat ticks.

“With our latest mild winter, ticks have been active in much of the region on warmer days all winter long,” said Jody Gangloff-Kaufmann, an entomologist at Cornell University in Ithaca, who said it’s too soon to predict population trends for 2020.

She added that it is clear, however, that ticks are expanding their geographic range and moving into colder regions. That’s why it’s important to know how to recognize them, take preventive steps and do a tick check each time you venture out.

“Although ticks aren’t everywhere, they can be anywhere so be aware of your surroundings,” Gangloff-Kaufmann said in a news release.

Though no notable change in distribution or density has been reported in the past year, there is one exception, according to Laura Harrington, director of the U.S. Centers for Disease Control and Prevention Northeast Regional Center for Excellence in Vector-Borne Diseases at Cornell.

Harrington said the Asian longhorned tick is expanding its range and has moved into New York state.

“So far, it hasn’t been found infected with human pathogens, but it does transmit a hemorrhagic viral disease in Asia,” Harrington said.

The bacterial infection that causes Lyme disease is the most important tick-borne illness in the United States, with an estimated 200,000 to 300,000 cases reported each year, she said.

“The blacklegged tick or ‘deer tick’ is the vector of Lyme disease in most of the U.S.,” Harrington said.

It also transmits other disease-causing organisms, including agents that cause babesiosis, anaplasmosis and Powassan disease. These ticks are most common in forested areas and shaded trail edges where there are lots of fallen leaves and shrubs, she said.

Female deer tick on human skin. It can transmit Lyme disease.

As such, you need to take steps to protect yourself when you’re headed outdoors.

Harrington recommends wearing repellent, light-colored clothing and tucking pants into your socks.

“You can also treat your clothing with permethrin or purchase permethrin-treated clothing,” she said.

But don’t stop with those steps.

It’s important to check yourself for ticks often.

“For Lyme disease, time is on your side,” Harrington said. “It usually takes 24 to 48 hours after the tick has attached and started feeding before it can transmit Lyme bacteria. For some other pathogens, like Powassan virus, transmission can happen quickly, so check yourself periodically for attached ticks even when you are still outside.”

Here’s how: Look for ticks all over your body, including on your back, neck and hairline.

If you find one, use sharp tweezers to remove it, grasping the tick as close to the skin as possible, then pulling.

Once you are back inside, remove your clothing and place it in a hot dryer for at least 20 minutes, if possible. If that’s impractical, place clothing in a sealed garbage bag and do it later, Harrington said.

“This is also a good time to take a shower and perform a tick check,” Harrington said.

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 (M.D.), Ernst Lamothe Jr., Payne Horning, Kyra Mancine, Patti Hogle • 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.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

•

Page 3

Meet

Your Doctor

By Chris Motola

Jai Singh, M.D.

General surgeon in Oswego discusses how the pandemic has changed the way he practices

Too Many Sugary Sodas Might Harm Your Kidneys Drinking lots of sweetened soda may increase the risk of developing chronic kidney disease, two new studies find.

“Consumption of 500 milliliters [16.9 fluid ounces] of a commercially available soft drink sweetened with highfructose corn syrup increased vascular resistance in the kidneys within 30 minutes,” the researchers found.

In a second study, the investigators found changes in blood flow in the kidneys was caused by the corn syrup, not the caffeine, in the soda.

The two studies included a total of 25 healthy men and women, with an average age of 22 to 24.

Christopher Chapman, of the University at Buffalo in New York, and colleagues explained that vascular resistance occurs when blood vessels constrict, reducing blood flow in the kidneys and increasing blood pressure and impairing kidney function.

“Collectively, our findings indicate that [highfructose corn syrup]-sweetened soft drink consumption increased renal vasoconstrictor tone at rest and during sympathetic activation,” the study authors said in a news release from the American Physiological Society.

The report was published online recently in the American Journal of Physiology — Renal Physiology.

Nearly 37 million Americans suffer from chronic kidney disease, according to the National Kidney Foundation.

The foundation estimates kidney disease kills more people than breast cancer or prostate cancer.

Page 4

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Q: How would you describe your role at Oswego Health?

A: I’m a general surgeon. I joined Oswego Hospital in 2014. I’m a local resident now and live here with my wife and our 6-year-old son and 4-year-old daughter. I did my medical residency in Westchester Medical Center. After that I came to Oswego Hospital. I do almost all kinds of general surgical procedures but my focus is more on laparoscopic surgeries, as well as general surgical procedures like skin biopsies, lumps and bumps and all those.

Q: How has the COVID-19 pandemic changed the way you practice?

A: What we’re doing now is seeing patients, bringing them into the operating room, and do the procedures on them. But let’s say someone is at home and experiencing gall bladder pain, we’ll be doing telemedicine

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

with them. If they do need surgery, we bring them into the operating room and perform the surgery.

Q: Elective surgeries are beginning to be allowed again. Can you give us some examples of elective surgeries?

A: What would be considered an elective surgery would be someone who has had a hernia for a long time and it’s not really bothering him or her that much. So those kinds of surgeries are more elective surgeries, which are not emergent or life-threatening. Sometimes those kinds of things can become life-threatening or at least emergent. In that case they do come to the emergency room. But in terms of elective surgery in my practice, someone has a skin lesion, lump or bump, but they aren’t cancer, then the patient may want to get rid of them, but they aren’t emergent or life-threatening. Those are elective.

Q: How has Oswego Health sorted patients into each category?

A: So, yes, all elective surgeries were canceled. So basically what we

do is see the patient with telemedicine, and if a patient needs elective surgeries, what I’m doing is putting them on a list. Once we start doing elective surgeries, we’ll call them and start scheduling them for the surgery. But if someone does need examination — because we only have limited examination options through telemedicine — then I’ll bring them to my office and examine them there, taking all the precautions that we need to take with COVID-19. But someone with an abscess can’t wait for a month or two. In the beginning, we didn’t even know how long the lockdown might go. So, it’s mostly emergent procedures we’re doing in terms of the OR. As a general surgeon, I’m on call to take patients in the emergency room, but in terms of the office, I’m making a list to schedule patients for elective surgeries when we can.

Q: How has the crisis affected your views on the effectiveness or limitations of telemedicine?

A: Telemedicine is actually very effective. I would say I wasn’t really using telemedicine at all before. Yes, I would answer patients’ calls and answer their questions, but I wasn’t doing any telemedicine. So, we started doing it when this started, and I found it to be very effective. Many times patients don’t need to come to hospital unless they need a detailed exam. It’s not the best, because the examination can’t be as good, but at least under the current circumstances, it’s the best thing we could do.

Q: What kinds of stresses has the disease itself put on your department?

A: We are still taking care of our community, so if a patient needs any emergent surgeries, they’re getting it done. I have told patients if they have any questions to call me and, if they need surgery, they’ll get it. So, in that regard, I don’t think there’s been that much impact. We do only have one operating room running right now, though, as opposed to the normal four. So there can be some wait because of that. I think the patients have been cooperative and understanding for us to open up again.

Q: Has the use of telehealth affected your work-life balance? How do you determine when you’ll be available?

A: Because the volume is not that much, I am available pretty much all the time. And that’s because we’re not doing elective surgery. Before I did have designated days and hours, but I don’t have that right now. So I’m available more for telemedicine now than ever before. As a general surgeon in a community setting, I want to assure that patients will be taken care of in every aspect.

Lifelines

Name: Jai Singh, M.D. Position: General Surgeon at Oswego Health Hometown: New Delhi, India Education: University of Delhi (medical school); Westchester Medical Center (residency) Affiliations: Oswego Health Organizations: American College of Surgeons; Society of American Gastrointestinal and Endoscopic Surgeons Family: Wife, son (6), daughter (4) Hobbies: Time with family

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June 2020 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 5

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Gardening Blooms While We Shelter in Place

H

ave you been to a gardening center or nursery lately?

Vegetable seeds are in short supply, if not sold out altogether. People are revisiting the basics during this coronavirus lockdown. Many are returning to gardening — especially vegetable gardening — given slim pickings at the super market.

As a vegetable gardener for years, I see this as a precious silver lining in this otherwise trying time.

And June is the perfect time for folks to dig in, get their hands dirty and grow their own vegetables at home.

It’s also a good time to reflect the many life lessons that gardening offers to those who live alone. It has taught me the value of planning, preparation, patience and pleasure — four essential “p’s” for a bountiful garden and ... a bountiful life.

Fertile ground exists in each of us, and a little tending can produce beautiful results.

Here’s what I have learned: • Plan. Realizing the garden of your dreams begins in your imagination, followed by careful planning.

Diagram your garden and it will help you avoid planting onions on top of potatoes or mistaking basil for a

weed.

Likewise, envisioning your life goals and committing them to writing can help you flourish and grow.

• Cultivate. Good, cultivated soil promotes healthy, deep roots. When you add fertilizer to your garden you are rewarded with abundance. Adding essential ingredients to the foundation of your dream garden (and your dream life) will nourish all that follows.

You can’t go wrong with nutritious food, a walk in nature, a good book, soothing music, or saying “yes” to a new adventure that’s been tugging at your heart.

• Plant. So many choices! Revisit your plan and embed your carefully selected seeds or seedlings with a tender, loving touch, being careful not to overcrowd or plant more than you can manage.

And remember: We reap what we sow, so follow your dreams. Plant a tomato and you get a tomato; plant a dandelion and you get a dandelion.

Seed your future with healthy choices that promote well-being.

• Weed. We all need room to breathe and space in which to blossom. It holds true for your garden and your life. Gardening is all about consistent caretaking. Slack off, even

s d i K Corner

Kids’ ER Visits for Mental Health Problems Soar Over 10 Years

C

hildren treated in America’s emergency rooms for mental health disorders jumped 60% over a recent decade, a new study finds.

Between 2007 and 2016, visits for self-harm like suicidal thoughts and cutting soared 329% and treatment for drug abuse rose 159%, according to the study led by Charmaine Lo, from Nationwide Children›s Hospital in Columbus, Ohio.

“This is happening in all emer-

Page 6

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gency departments all across the country and in kids of all ages,” said Lo. “And regardless of whether it’s a children’s hospital or a general hospital, and whether or not they’re in an urban location or in a rural location.”

Lo thinks that social media has put a lot more pressure on children.

“Children, particularly teenagers, are feeling that. Also, there’s a lot more awareness of mental health, and children know that there are resources in place for them to seek help and get

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

‘June is the perfect time for folks to dig in, get their hands dirty and grow their own vegetables at home.

It’s also a good time to reflect the many life lessons that gardening offers to those who live alone.’ for a few days, and all things unwelcome show up and take root.

Weed out the negativity and any dream-stealing toxins that contaminate your life, dash your hopes, or spoil your fun. When you pull out the bad, you can more easily focus on the good in your life.

• Prune. When weeding is not enough, a major pruning may be in order. A job, relationship, or home that no longer satisfies or meets your needs may need a hard look. It may be time to pull out that pair of “life loppers.”

• Mulch. Mulching keeps weeds at bay and the ground moist, and returns nutrients to the soil. It also adds a finishing touch.

Mulch offers a blanket of protection, in the same way that regular doctor appointments, insurances, and safety measures protect our lives. We

help,” she said.

The coronavirus pandemic is only going to make things worse, experts say.

“Although this study was conducted prior to the onset of the COVID-19 pandemic, the increase in social isolation and household stressors caused by the pandemic are likely to further worsen children’s mental health” said physician Jennifer Hoffmann from the emergency medicine division at the Lurie Children’s Hospital of Chicago.

A study from China showed that children affected by the COVID-19 pandemic had more symptoms of anxiety and depression, Hoffmann said.

The study researchers worry that emergency departments aren’t equipped to handle mental health problems in children, especially small hospitals in rural areas.

“Preparation could be as simple as a screening training program for the nurses and doctors, because you don’t have to be a psychologist to take care of these kids, you just need to recognize whether they’re dangerous to themselves or others,” said study co-author physician Rachel Stanley, division chief of emergency medicine at Nationwide.

“Those tools are currently available through various agencies, although they aren’t being used by most of the places that are taking care

can learn a lot from mulching.

• Wait. We all know that “good things come to those who wait.”

Enjoy the gradual unfolding of a garlic scape, a lettuce leaf, an idea, or a friendship. When you exercise patience, life can be savored and more deeply appreciated.

• Each year, I look to my garden to remind myself that growth takes time.

• Enjoy. Before you know it, your labor of love and patience will pay off. Take pleasure in the transformation as the colors, textures, and fragrances emerge. Too often, we fail to “stop and smell the roses” in our gardens and in our lives.

So get busy, then step back and take a good look. There’s nothing quite as satisfying as admiring what you’ve accomplished. It’s reason to celebrate!

By osmosis, gardening has taught me how to take better care of myself. I have absorbed its rich messages and learned how to nurture my inner garden and growth as a woman on her own.

I encourage you to grab a spade and join me. Beauty, growth, and an energizing sense of renewal can be yours, season after season after season.

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.

of these kids,” Stanley said.

For the study, Lo and her colleagues analyzed data for children aged 5 to 17 from Nationwide’s emergency department databases.

The researchers found that, while the number of children seen in the emergency rooms remained stable between 2007 and 2016, visits for mental health problems increased dramatically.

Visits for alcohol problems actually fell 39%, while overall drug use visits grew substantially. This bears more investigation, the researchers said, given the opioid epidemic still raging in the United States.

The types of mental health problems reviewed included adjustment and anxiety disorders; attention-deficit, conduct, and disruptive behavior disorders; impulse control and mood disorders; and psychotic disorders like schizophrenia.

One in five U.S. children has a mental health disorder, according to background notes. Children with mental health disorders make up about 2% to 5% of all pediatric ER visits nationally, and this number is increasing. Until now, few studies have looked at where these kids go in an emergency, Lo and colleagues said.

The report was published online May 11 in the journal Pediatrics.

By the Numbers, COVID-19 Was Never ‘Like the Flu’

I

n the early days of the coronavirus pandemic, President Donald Trump announced that Americans need not worry because the new coronavirus was “like a flu.”

Now, 1.4 million cases and more than 84,000 COVID-19 deaths later (as of May 17), a new report finds the comparison was never valid.

“Public officials continue to draw comparisons between seasonal influenza and SARS-CoV-2 mortality, often in an attempt to minimize the effects of the unfolding pandemic,” wrote physicians Jeremy Faust, of Harvard Medical School, and Carlos del Rio, of Emory University School of Medicine in Atlanta.

But those comparisons are “apples and oranges,” the physicians reported in an article published May 14 in the journal JAMA Internal Medicine.

That’s because the numbers comparing COVID-19 and flu just don’t match up.

For example, the U.S. Centers for Disease Control and Prevention produces an annual tally of deaths caused by flu. During the 2018-2019

flu season — by all accounts a moderate one — 34,200 Americans are thought to have died from complications linked to the flu. In more severe flu seasons, that number can go higher — the 2017-2018 season was linked to more than 61,000 deaths, for example.

However, Faust and del Rio noted that confirming that flu caused a patient’s death (and not some other underlying condition) is often tough, so the CDC long ago issued their numbers as “calculated estimates” — not actual death counts as verified by death certificates.

An annual number for verified flu deaths also exists, however, and it’s much smaller than the calculated estimates.

Between 2013 and 2019, “the number of counted influenza deaths was between 3,448 and 15,620 yearly,” the report authors noted.

Conversely, COVID-19 deaths occurring in 2020 have all been counted, not estimated.

That means that by May 14, the more than 84,000 deaths from coronavirus are already about 5.5 times

higher than the highest annual death count for the flu over the past seven years.

Those ratios widen even further when deaths are looked at on a weekly basis.

“Statistics on counted deaths suggest that the number of COVID-19 deaths from the week ending April 21 was 9.5-fold to 44.1fold greater than the peak week of counted influenza deaths during the past seven influenza seasons in the U.S.,” Faust and del Rio said.

Finally, there’s simply no comparison between flu and COVID-19 when it comes to what medical staff are experiencing on the frontlines.

“In some hot zones of the pan-

demic … ventilators have been in short supply and many hospitals have been stretched beyond their limits,” the two experts noted. This overwhelming demand on hospitals, “has not happened before in the U.S. even in the worst of influenza seasons.”

Finally, they said, the actual death count of COVID-19 may be even higher than current estimates, because “indirect” deaths linked to the pandemic aren’t factored in.

Those include deaths that occurred because people with other, often fatal conditions couldn’t get the help they needed as health care systems became overwhelmed by COVID-19.

and group psychotherapy that are delivered in temporary expansion locations, including the patient’s home. Normally, patients would be required to receive these services at the community clinic.

‘CMS is allowing physicians, licensed in a particular state, to bill for telehealth services provided to their patients who may live across state lines.’

Healthcare in a Minute

By George W. Chapman

CARES Act Expands Beneficiary Coverage for COVID-19, Gives Providers Flexibility

I

n late April, the Centers for Medicare & Medicaid Services (CMS) issued radical changes to combat the COVID-19 pandemic. The Coronavirus Aid, Relief, and Economic Security Act expands beneficiary coverage for the virus and gives providers greater flexibility in delivering care. Some of the important provisions are summarized below. It should be noted that CMS rules pertain to Medicare and Medicaid beneficiaries. However, most commercial carriers tend to mimic CMS especially during this pandemic. If you are covered by a commercial plan, to be sure about coverage, contact them first.

Testing

You do not need a written order from your treating physician to get tested for the virus. An order (it does not have to be written) from any qualified healthcare practitioner authorized to do so under state law will be accepted. Pharmacies can do testing if enrolled with CMS as a lab. Beneficiaries can now be tested in so called “parking lot” sites operated by qualified entities such as hospitals, community health centers, pharmacies, etc. CMS will pay for the services related to the virus in full.

The beneficiary will not be responsible for any deductible or co-pay.

Inpatient facilities

Hospitals are allowed to temporarily increase their number of beds to accommodate COVID-19 patients.

Inpatient psychiatric and rehab facilities may admit COVID-19 patients to relieve the pressure on hospitals.

CMS has made it easier for inter-facility transfers.

Practitioners

Advanced practitioners (nurse practitioners, physician assistants, clinical nurse specialists) can provide home health care without physician certification. APs can order the services, establish care plans and certify that the patient is eligible for home care. Teaching hospitals are allowed to send available residents to other affiliated or non-affiliated hospitals to help out. Physical and occupational therapists can delegate routine maintenance services to their qualified assistants. During the COVID-19 emergency, hospitals and ambulatory surgery centers will not have to periodically reappraise staff privileges. This allows them to keep providers whose privileges would normally be expiring. It also allows them to temporarily bring retired physicians back.

Mental health delivery

CMS will allow and pay for individual psychotherapy, education

Telehealth

These temporary changes will most likely have the most profound and enduring impact on the delivery of care far beyond the pandemic. Up until the pandemic, telehealth was used sporadically and traditional face to face encounters were preferred.

Red tape and low payment discouraged both physicians and patients from using telehealth. CMS and commercial carriers have long feared the easy use of telehealth would merely increase utilization without any real impact on outcome. As the pandemic lingers, both consumers and providers are adapting to telehealth.

Most likely, some of these temporary changes below will become permanent.

Physical, occupational and speech therapists can provide services via telehealth. Hospitals may provide and bill, as the originating site, for telehealth services provided to registered outpatient in their home. The patient’s home becomes an extension of the hospital’s outpatient department. Services provide remotely include counseling, education and therapy. Telehealth may be provided by audio only (telephone) versus audio and visual. Medicare is now covering some services when provided as audio only — this includes behavioral and patient education services. CMS has (finally) increased payments to providers for telephone encounters to match payments for traditional office visits.

June 2020 •

This is retroactive to March 1. CMS has promised to add to the list of approved telehealth services and to accelerate the approval process on a “sub-regulatory” basis. (As providers and consumers adapt, I think it will be very difficult for CMS to go backwards on telehealth once the pandemic subsides.) CMS is now paying rural clinics and federally qualified community health centers for providing telehealth services.

CMS is allowing physicians, licensed in a particular state, to bill for telehealth services provided to their patients who may live across state lines.

George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

•

Page 7

My Turn The Million-Dollar Question: How Effective Are Probiotics?

By Eva Briggs

A

ll manner of microorganisms inhabit our bodies in complex communities called microbi-

omes.

It’s akin to having a microscopic forest — composed of bacteria, fungi and other tiny creatures rather than made of trees and plants — inside our digestive tract, mouth, nose and skin.

These creatures affect the immune system, help protect against infection and maintain the intestinal barrier.

These microbiomes can be disrupted by disease, by drugs such as antibiotics or other forces. It seems plausible that administering appropriate live microorganisms will restore balance. This is the concept behind probiotics.

Many probiotics are commercially available. But the million-dollar question remains — are they effective?

To answer that question requires high quality scientific data which is often lacking.

That’s because the FDA categorizes products by claims the manufacturer makes, not by their ingredients. If a manufacturer says

that a product cures, treats, prevents or mitigates a disease, the product is classified as a drug. New drugs require extensive and expensive testing prior to approval.

If a product makes a “structure-function” claim, it can be marketed as a dietary supplement.

A structure-function claim uses words like “may help,” “supports” or “promotes.” Some actual examples I found on a quick Google search: “Supports healthy digestion.”

“Boosts the immune system.” “Nurtures the gut.” “May help maintain intestinal health.”

Unfortunately, it’s hard for the average consumer — and for many health professionals — to distinguish these nebulous statements from FDA-approved health claims.

An example of an FDA-approved claim would be “Relieves heartburn” for the drug famotidine or “indicated for short-term treatment of erosive esophagitis” for the drug omeprazole.

Dietary supplements must include the disclaimer that their statements have not been approved by the FDA and are not intended to diagnose, treat or prevent disease.

Many people don’t realize that dietary supplements are not tested for safety. They are not analyzed to determine effectiveness. Their contents are not analyzed for purity. The FDA has not approved any probiotic as a live therapeutic agent.

For most probiotics, many studies are low quality and at high risk of bias. It doesn’t mean that probiotics are not useful; it’s just that data is lacking.

Even more troubling is the assumption that probiotics could not be harmful because they are sold as dietary supplements. It appears that “can’t hurt” is probably true most of the time, but there are a few cases of harm. For example, some children in a pediatric intensive care unit given an organism called “Lactobacillus rhamnosus GG” developed bloodstream infections from this bacterium. In a study of adults with pancreatitis, the death rate was significantly higher for patients receiving probiotics.

Eva Briggs is a medical doctor who works at two urgent care centers in the Syracuse region.

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Page 8

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

UPSTATE PHYSICIANS FROM LEFT: Timothy D. Ford, MD Luna Bhatta, MD Robert L. Carhart, Jr., MD Debanik Chaudhuri, MD Hani Kozman, MD Sakti Pada Mookherjee, MD Avneet Singh, MD Tama Szombathy, MD Amy Tucker, MD Daniel Villarreal, MD

Cancer Program Offers Tips to Stay ‘Sun Safe’

By Patti Hogle

emorial Day just marked the beginning of warmer weather and that means tank tops, shorts, sandals, masks and sun.

With all the talk of social distancing, it is easy to forget the importance of keeping everyone safe from too much sun exposure.

Did you know ultraviolet (UV) radiation from the sun is a major cause of all skin cancers and one in five Americans will get skin cancer in their lifetime?

The good news is you can enjoy the sunshine safely by taking precautions against the sun’s harmful rays.

Here is what you can do to be safe while enjoying the outdoors: • Avoid Sun Tanning and Tanning Beds: UV light from tanning beds and the sun causes skin cancer and wrinkling.

• Apply Sunscreen: Generously apply sunscreen to all exposed skin using a sun protection factor (SPF) of at least 15 that provides broad-spectrum protection from both UVA and UVB rays. Reapply every two hours, even on cloudy days, and after swimming or sweating.

• Cover Up: Wear protective clothing, such as a long-sleeved shirt, pants, a wide-brimmed hat and sunglasses.

• Seek Shade/Use Umbrellas: Seek shade when appropriate. Remember that the sun’s UV rays are strongest between 10 a.m. and 4 p.m.

• Start sun protection habits at an early age.

To learn more about the Cancer Prevention in Action Program, which is supported with funds from the state of New York, please visit takeactionagainstcancer.com.

Patti Hogle is Cancer Prevention in Action project coordinator.

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28th Annual AIDS Walk/Run goes virtual

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CR Health announces that its 28th Annual AIDS Walk/Run will continue as scheduled at 10 a.m., Sunday, June 7, as a virtual event.

Participants will sign up to receive private links to a Zoom video conference. They are encouraged to tune in on their mobile devices to enjoy a walk, run, or celebrate outdoors as a community while practicing social distancing.

Prior to the AIDS Walk/Run, individuals can donate and request donations to support their own personal fundraising efforts.

All proceeds of the AIDS Walk/ Run will support ACR Health’s mission to create healthy communities by fighting HIV/AIDS, substance use, and poverty and standing up for LGBTQ equality.

Event’s sponsors are Gilead, Dr. Cathy J. Berry & Associates, Empower Federal Credit Union; Excellus BCBS; Wegmans; Kinney Drug Foundation & Noble Health Foundation; Community Bank; Advance Business Systems; Pharm Blue; and Health E Connections.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

•

Page 9

PUR: New Test May Help Determine Prostate Cancer Risk How effective is the new urine test for prostate cancer? It’s been available for about a year now. Is it working?

By Deborah Jeanne Sergeant

A

fter receiving a diagnosis of prostate cancer, men and their healthcare providers have many decisions to make together.

Prostate cancer treatment can result in urinary incontinence and impotence, and since many prostate cancers are slow-growing, a man may be a good candidate for active surveillance, depending upon many factors such as comorbidities, age and ethnicity.

Other than periodic check-ups to ensure the cancer isn’t growing, he may not require further treatment.

Historically, testing has involved a prostate specific antigen (PSA) blood test, digital rectal exam and biopsies to determine if their cancer is growing. Understandably, prostate cancer patients don’t like the invasive tests.

About a year ago, researchers in the UK announced a new prostate urine risk (PUR) test that may help test risk of their cancer becoming more aggressive. The trial included 500 men, most of whom had prostate cancer. It was able to detect men who are up to eight times less likely to need radical treatment within five years.

Urologist Joseph M. Jacob of the department of urology at Upstate Medical University said that at present the PUR test needs further research, but he’s interested in its potential, especially if it could reduce Jacob the need for other tests.

“It could be a real game-changer and make a big difference,” Jacob said. “Even a blood draw can be stressful for guys.”

The PUR test looked at the

biosignature or genetic profile of patients and found 36 genes that enabled them to determine risk.

A blood or urine test is much less invasive than biopsy. The PSA blood test also gives false results — both negative and positive — so something more accurate that could prevent the need for a biopsy would benefit patients.

Jacob encourages men with prostate cancer to discuss all the options available. He said that a problem with the PSA blood test is that it’s not as accurate as physicians would like.

The test isn’t specific to prostate cancer as any number of health factors could elevate a man’s PSA without reflecting the presence of cancer or the aggressiveness of an existing cancer.

The US Preventive Task Force has questioned the benefit of the

PSA a few years ago because of false results; however, it has since said it offers some merit and it remains part of the ways urologists test for and manage prostate cancer.

A newer tool in the urologist’s toolbox is the 4-K blood test, which tests a few molecular variations of the PSA and uses a formula, including biopsy history, age and other factors to give a number indicating risk.

“It’s been shown it’s more accurate than PSA,” Jacob said. “It’s not perfect — no test is — but it’s 70% accurate. It gives men a personalized risk assessment for their likelihood of having aggressive prostate cancer.

They can decide to watch it for now or get a biopsy.”

Prostate MRI is being used more than ever with diagnosed men, as biopsies can be painful and cause

infection. Health insurance typically covers annual prostate MRI for patients with a negative biopsy and elevated PSA or those diagnosed with cancer and are on active surveillance.

MRI can also guide biopsy if providers see something that looks like cancer.

“It’s exciting because you can get very good images of the prostate and there’s very good data coming out about how MRIs have been effective in preventing men from getting prostate biopsies,” Jacob said. “If the MRI is completely negative, we may say, ‘Your risk is low, so we’ll skip the biopsy.’”

Physicians can use MRI to focus radiation therapy on that focal point instead of treating the entire prostate.

Physician David Albala, with AMP Urology in Syracuse, said that of the 1.2 million prostate biopsies performed in the U.S. annually, about 65% to 75% are for benign or low-grade cancer that Albala won’t need treatment.

“It’s no question: we over-treat prostate cancer,” Albala said. “Many don’t need treatment.”

Like Jacob, he said that urologists have no perfect test. He estimated that rectal exam is about 50% accurate and high PSA can indicate issues or traits not related to cancer, causing a false negative.

That’s why urologists use multiple types of tests and assessments to help determine risk, such as a biomarker test, the Select MDx urine test. It screens the genes for signs of significant prostate cancer.

“It essentially assesses the aggressiveness of a patient’s cancer,” Albala said. “It’s used as two biomarkers. Together, those biomarkers have about a 76% sensitivity reliability for determining cancer that’s aggressive.”

Albala encourages men to seek screening at 40 if they’re black or have family history of prostate cancer or at age 54 otherwise.

“Have an informed discussion with your doctor about it,” Albala said. “It’s shared decision making.”

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

• Reiki, & Pranic Healing • Integrative Nutrition Holistic Health Coaching • Medical Marijuana & Medical Grade CBD Oil • Seasonal Detoxes

Urology_MeetTheTeam_2132020_Full.qxp_Layout 1 2/14/20 10:01 AM Page 1

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

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

NICK LIU, MD

Kidney Stones, Minimally Invasive Kidney Surgery, Enlarged Prostate

SCOTT WIENER, MD

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

RYAN SIDEBOTTOM, DO

JOSEPH JACOB, MD

General Urology, Endourology and Laporoscopic Surgery

EDWARD IOFFE, MD

RAKESH KHANNA, MD

General urology

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

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

General Urology; Female Urinary Incontinence

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Urologic oncology; robotic surgery of prostate, kidney, bladder

TOM SANFORD, MD

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

STEPHEN BLAKELY, MD

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SERGEY KRAVCHICK, MD

DMITRIY NIKOLAVSKY, MD

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ELIZABETH FERRY, MD

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

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

MATTHEW D. MASON, MD

JC TRUSSELL, MD

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

NATASHA GINZBURG, MD

OLEG SHAPIRO, MD

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

MRI fusion, male health, prostate cancer and kidney stones

TIMOTHY K. BYLER, MD

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

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

HANAN GOLDBERG, MD

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

ANTHONY J. TRACEY, MD, MPH, FAAP

UROLOGY

FOR QUESTIONS OR TO MAKE A REFERRAL, CALL 315.464.1500 June 2020 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

•

Page 11

5

Things You Need to Know About Low Vision

By Ernst Lamothe Jr.

A

ll of your five senses matter.

The deterioration of any of them can greatly decrease quality of life.

When it comes to vision, there are a variety of issues that may present themselves — blurriness, difficulty distinguishing distant and nearby objects, blind spots and fading of colors, among others.

Different eye conditions affect vision in unique ways. Almost 12 million people aged 40 years and older in the United States have vision impairment, according to the Centers for Disease Control and Prevention.

“The eyes are how we take in the world whether that is reading, taking a walk, playing with your grandchildren and other people you love, enjoying nature or doing our practical everyday tasks,” said optometrist George Kornfeld, who has been providing low vision services for 47 years. “Routine eye examinations throughout one’s life are important in order to identify abnormalities and provide appropriate interventions.”

Kornfeld, who sees patients in Syracuse and other locations in Upstate New York, talks about eye conditions and what can be done about them.

1.What is low vision?

Low vision is a general term used when eye function is below a certain threshold and impacts its function. The condition includes macular degeneration, which affects the macula, causing slow progressive deterioration of central vision. Even though this can happen at any age, it is more common among the elderly.

People with macular degeneration frequently respond well to specialized devices such as magnifiers, telescopic glasses, prismatic high-power

reading glasses, closed circuit television reading systems.

“These electronic devices enhance vision and facilitate independence. Visual problems are often invisible and cause challenges in everyday activities, mobility and social interactions,” said Kornfeld.

devices can help improve low vision?

2.What

A low vision practitioner evaluates a patient’s functional vision and their personal visual goals. There are several types of eyewear that Kornfeld may prescribe to meet the visual needs of low vision patients.

Among them are hand-held magnifiers, filters and large print materials.

He may suggest telescopic eyeglasses or prismatic eyewear, which are strong magnifiers mounted in glasses to alleviate the need to hold a hand magnifier. Another type of low vision device is tinted E-scoop glasses which magnify an image and help with distance vision.

“Some of my patients consider me the last stop for people who have vision loss,” said Kornfeld, one of a small number of doctors in the world who specialize in fitting bioptic telescopes. “These are powerful enhancements that take away the need for someone to read with a physical magnifying glass going from page to page. Some telescopes enable a patient to watch television, see concerts and plays, and even continue driving.”

3.Live a healthy life

Although one cannot always prevent disease, there are some proven methods to decrease the odds. Vision experts recommend not smoking, taking eye vitamins, eating green leafy vegetables, antioxidants

and eating more fish and nuts, which may slow the progression of macular degeneration. People with diabetes can experience day-to-day changes in their vision called diabetic retinopathy. Diabetes can cause blood vessels that nourish the retina to develop tiny, abnormal branches that leak.

This can interfere with vision and, over time, may severely damage the retina.

“If you practice overall good health, exercise, make sure your blood pressure and cholesterol are low, you are doing all the correct things in life to maintain good visual health,” said Kornfeld, who is a fellow of the American Academy of Optometry and the International Academy of Low Vision Specialists.

An ophthalmologist or an optometrist can check for eye health and treat medical eye conditions and determine the status of your vision.

“My job as a low vision optometrist is to figure out everything and anything possible to enhance functional vision so that my patient can do the things they love to do and need to do. Losing eyesight is a crisis both practically and emotionally. Patients need to know their options.”

4.Wear protection

Optometrist George Kornfeld has been providing low vision services for 47 years. He sees patients in Syracuse and other locations in Upstate New York. to be out for longer periods of time whether that is driving or doing outdoor activities like gardening.

To protect your eyes from harmful solar radiation, you should wear sunglasses that block 100% UV rays whenever you are outdoors in the daylight. The World Health Organization estimates up to 20% of cataracts may be caused by overexposure to UV radiation.

“You want to make sure you are protecting your eyes from the sun which is essential,” he added. “We recommend that people wear sunglasses especially if they are going

are some of the signs of low vision?

5.What

Symptoms of low vision include blurry and blind spots, changes in ability to watch television, see traffic signs, drive at night, read, and navigate safely. People who experience these difficulties should consult an eye professional.

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Restless Leg Syndrome is Treatable

By Deborah Jeanne Sergeant

A

re your legs keeping you up at night? Restless leg syndrome may be the culprit. The central nervous system causes the condition which typically manifests at bedtime — but not while someone’s asleep.

Physician Jacob Dominik, medical director of the Ghaly Sleep Center in Syracuse, said many people think restless leg syndrome awakens them at night; however, that’s periodic limb movement.

“Restless leg syndrome symptoms are felt by patients when they’re awake in evening before bed,” he said.

He added that symptoms may appear in the legs or other areas of the body and feel like an ache, itch, wiggle or tingle that cannot be relieved until the patient moves.

Ignoring it only allows it to build. As patients stop moving, the symptom returns.

Periodic limb movement involves involuntary and repeated movement of the limbs during sleep, which can cause patients to awaken.

The movement occurs at least four times consecutively between five and 90 seconds.

Since lack of movement is important to start sleeping, restless leg syndrome can prevent sleep. On the other hand, periodic limb movements disrupt sleep.

Though some people experience restless leg syndrome as a minor

nuisance, some find it so bothersome that they seek treatment. It may have a genetic component.

Other sleep issues, like sleep apnea, worsen restless leg syndrome.

“We first address any underlying sleep disorders,” Dominik said.

Medication such as antihistamines, antidepressants and others can contribute to sleep issues.

Dominik also looks at iron levels, since low iron has been linked with restless leg syndrome.

Dominik explained that low levels of dopamine in the brain seems to affect restless leg syndrome and iron is thought to synthesize dopamine.

“What’s important is we look at ferritin, a measure of iron stored in the body,” Dominik said. “It’s important to note that the level of ferritin you want for iron is different than what you want for leg symptoms. Someone might go to a doctor for unrelated reasons and be told their iron levels are fine.”

The level of iron stored in the body should be up to three times the amount tested in the blood. Patients found deficient are advised to take iron supplements, which take about three months to improve their levels.

“You shouldn’t just take it without having it checked as you can have an overload,” Dominik said.

Restless leg syndrome sometimes appears — and, if pre-existing, worsens — with pregnancy, since

pregnancy may deplete the body’s iron stores.

Changes in the diet may help improve restless leg syndrome. In addition to iron, Laurel Sterling, registered dietitian with Carlson Labs in Canastota, recommends looking at magnesium.

Eating magnesium rich foods “also helps with sleep,” she said.

“Eat almonds, avocadoes and black beans, for example.”

It can also help if patients use good “sleep hygiene” such as keeping the bedroom dark and quiet, avoiding caffeine and engaging in a relaxing activity before bedtime.

Light exercise may help; however heavy exercise right before bed can worsen restless leg syndrome.

Physician Az Tahir, who practices holistic health at High Point Wellness in Syracuse, recommends a bath with Epsom salts and lavender oil for

relaxation.

“Have massage before you go to sleep,” he also said. “Chamomile tea is very good and lavender oil in a diffuser.”

He has also suggested noise machines to help create a restful environment.

Sleep specialists may also prescribe medication that increases dopamine or helps calm the nervous system.

“It’s a condition that’s very treatable,” Dominik said. “Some just think it’s a nuisance or made up by pharmaceutical companies, but it’s a real condition with a neuro-biological basis. When people are questioned about the impact on quality of life, it is like people with multiple sclerosis.

It’s readily and easily treatable.”

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Parenting

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f there is one thing our fractured society might actually be able to agree on right now, it’s none of us like to feel helpless.

The lack of control we have over our present circumstances is something most of us are grappling with.

Our collective discomfort with the unpredictable is a uniting stressor.

Parenting in uncertain times As a parent, I face many challenges (and have many blessings) during quarantine, and one of them is navigating the fear of the unknown. My family is learning how to thrive in a world lacking definition and certainty. The day-to-day stuff is easy enough to plan for. We can set clear expectations for the perfunctory.

What I can’t offer my children are many long-term answers. Anyone who knows how children work understands this is a mini disaster in the making. Children want to know what’s next. They want to know what’s happening 10, 15 and 20 minutes from now, as well as what’s happening tomorrow and the next day. Children desperately crave plans and control.

Regaining and sharing the control

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

With so much out of our control right now, how can parents give children the structure they crave? How can we give it to ourselves?

We can strive to control the controllable and relinquish some of that control to our children. When people feel like they have control of their choices, they often feel more at peace with their circumstances.

When my kids are frustrated because they feel powerless, I can delegate minor choices to them. I can offer myself and my family some security by recognizing what we can control.

Here are some ideas for how to regain control in our lives.

The division of power I can control how often we go to the store and how much exposure I have to the public. My children can make a small grocery list or contribute to meal plans, so they feel like they have some control of their food.

When it comes time for lunch, I can give my kids two choices. I don’t care if I throw PBJ or cold cuts on bread, so why fight over it? I can control what snacks go in the snack basket.

They can choose which snack to eat today. Whatever snack they don’t eat

will be what’s left on Friday.

I can control how much and what types of news I consume. By doing this with prudence, I can choose what narratives I expose my kids to. I can offer them age-appropriate and factual information regarding the pandemic. I can remove much of the fear factor for them. I can guide how they feel by controlling my own reactions.

When my kids act up out of frustration or boredom, I can control how I react to their behavior. I can teach them to be accountable for their own behavior and help them work through difficult emotions. I’m not responsible for their bad behavior and they aren’t responsible for mine.

I can decide what crafts and experiments are options. My children can decide which ones to do and in what order. I can control what time my kids go to bed and keep them on a schedule. They can control what books we read before bed and what songs we sing.

When it comes to schoolwork, I can control how much work gets done. In most cases, the order it gets done is inconsequential. Thus, I can let them choose how they reach the finish line. When it comes time for tablets, I can control how long my children play them and what games they play. They can control whether or not they get to play them (by finishing their schoolwork first).

I can give them a list of chores to do, and they can choose which ones to finish and finish well. They know there are consequences for unfinished or sloppy chores, so they can decide if they want to deal with the consequences and forgo rewards.

I can control how much my family helps other families and loved ones during this crisis. I can give my kids a list of family members to call and let them decide whom to call on what days. I can decide to send cards to others; my kids can pick whom we send cards to. I can choose to bake and share with neighbors; my kids can choose what to bake (sometimes).

I can choose to take the kids on walk to chalk driveways; they can choose what to draw.

Lastly, I can control how I manage my own emotions during this pandemic. I can allow myself to feel the many complicated feelings I have. There will be off days, and that’s ok. However, I owe it to myself and my family to recognize the ephemeral nature of our situation and keep a hopeful tone in my home.

SmartBites

The skinny on healthy eating

Red Snapper Pops with Healthy Benefits

H

ere’s a quarantine surprise: More people are cooking seafood, especially now that certain meat products are becoming harder to find.

Here’s a surprise of a different nature: Snapper, a popular white fish with a firm texture and a distinctive sweet, nutty flavor, has a nutritional profile that’s bound to intrigue.

To begin, snapper is an excellent source of lean, high-quality protein, with an average serving delivering about 40% of our daily needs. What makes snapper’s protein particularly attractive is that, unlike, say, a comparable serving of ground beef, it’s much lower in fat, calories and sodium. What’s more, it has an admirable water footprint: snapper, 0 gallons; one hamburger, 450-600

gallons. We need protein to build and repair tissues, regulate hormones and increase feelings of fullness.

Snapper is a vitamin B12 superstar. This high-priority vitamin helps to produce red blood cells and DNA, keep nerves healthy, promote bone health and synthesize serotonin — the “happiness” chemical.

Many studies support that vitamin B12 may boost energy, slow mental decline and improve moods. Since many older people suffer from a B12 deficiency — whether through diet or poor absorption — it’s good to know that seafood is a great source of this essential B vitamin.

Another nutritious hook? An average serving of snapper contains 50% of our daily needs for selenium.

A powerful antioxidant that helps

Helpful tips

By Anne Palumbo prevent cell damage, selenium is required for the thyroid gland to work properly and plays an important role in the health of our immune system.

This flavorful fish is also a good source of omega-3s — healthy fats that have been linked to a lower risk of many life-threatening conditions.

According to experts at the Cleveland Clinic, omega-3s have been shown to increase levels of good cholesterol and reduce blood clots, blood pressure, and inflammation.

While all fish, including snapper, contain some cholesterol, they can still be part of a heart-healthy diet.

The good news is, it’s the saturated fat in food that raises blood cholesterol levels, not so much the dietary cholesterol, and snapper is super low in saturated fat. It’s also relatively low in cholesterol: an average serving of snapper, 37 mg of cholesterol; an average serving of shrimp, 190 mg.

As for its mercury levels, snapper is a “good choice” to eat once a week, according to the FDA. This advice is particularly helpful for women who are pregnant, breastfeeding mothers, and young children.

Grilled Red Snapper with Black Beans Serves 4

1 teaspoon olive oil 2 red snapper fillets (halved) 1 teaspoon paprika 1/4 teaspoon cayenne (optional) 1 teaspoon salt 1/2 teaspoon garlic powder 1 teaspoon dried thyme 1 teaspoon dried oregano 1/2 teaspoon coarse black pepper 15 oz. can black beans, rinsed and drained 3 tablespoons chopped red onion 1 garlic clove, minced 1 tablespoon olive oil 2 teaspoons red wine vinegar 1 teaspoon Dijon mustard 1/2 teaspoon salt 1/4 teaspoon coarse black pepper

Snapper fillets are readily available fresh and frozen. Fresh fish should be cooked the day it is purchased; however, it will keep for two days in the refrigerator if properly wrapped. Although it’s best to eat snapper the day it’s prepared, any leftovers will last three to four days in the refrigerator. Using a “grill pan” facilitates cooking snapper on the grill.

Lightly coat both sides of snapper with olive oil. Mix together the paprika, cayenne, salt, garlic powder, thyme, oregano and black pepper.

Sprinkle over each side of the red snapper. Set aside.

Before grilling, coat your grates with a high-heat cooking oil, such as canola oil (spray or a paper towel coated with oil will work). Do the same if using a grill pan. Preheat the grill to high heat for 10-15 minutes.

While grill is preheating, combine the beans, onion, garlic, olive oil, vinegar, mustard, salt and pepper in a medium saucepan. Cook, uncovered, over low heat for 10 minutes, stirring occasionally. Remove from heat and cover.

Grill the snapper about 5 to 6 minutes on each side or until the fish reaches an internal temperature of 145 F. Serve topped with black bean mixture.

(No grill? Heat 2 tablespoons canola oil in a large skillet over medium-high heat. Place snapper fillets in skillet and cook about 5 minutes on each side.)

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.

Losing ‘COVID-15’ After Quarantine

By Deborah Jeanne Sergeant

T

he “freshman 15” weight gain experienced by many college students shares some similar origins of the “COVID-15” pounds packed on during quarantine: mindless stress eating, availability of food, boredom, poor food choices and lack of exercise opportunities.

Plus, those who are working at home had little positive peer pressure. At the office, others would notice that second or third doughnut.

Also absent at home are the lunchtime walking group, buying a healthful lunch at a nearby eatery and hitting the gym on the way home.

While working at home, it’s easier to binge on unhealthful convenience foods and stressful news updates. Familiar movies in the evening — instead of workout videos — offer comfort.

Despite the ease of gaining weight, it’s possible to shed unwanted pounds.

Physician Az Tahir, who practices holistic medicine at High Point Wellness in Syracuse, said that it helps to incorporate more movement June 2020 •

into each day — and not just during a formal workout time.

“Exercise should be part of a lifestyle,” he said.

Exercise and stretching can help combat the weight-gain effects of stress. Tahir said he walks for half an hour before breakfast and half an hour before dinner to burn calories, boost his alertness and aid in digestion.

He also recommends substituting not-so-healthful cravings for healthful activities, such as reaching for the yoga mat instead of a cookie for a mid-afternoon lift and to reduce stress.

“When you’re at home or at work, every hour, do a yoga stretch, relax your back or neck,” Tahir said.

“Many yoga stresses are very good.

Just do it for two or three minutes.

That will prevent back problems when working. You feel like a new person.”

He also advises to watch porcontinued next page

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 15

For Mental Health, the Impact from COVID-19 Is Far From Over Situation may worsen after economy reopens, says expert

By Payne Horning

M

onths of isolation, rising unemployment and general uncertainty have taken a toll on the nation’s mental health.

Forty-five percent of the people the Kaiser Family Foundation polled in a recent survey said the virus has negatively affected their mental health — 19% of whom said that it had a major impact — and crisis hotline services across the country have reported major volume increases since the start of the outbreak.

Even as states like New York slowly reopen and people are finally able to gather together and return to some of their regular routines, mental health providers say the situation won’t necessarily get better. In fact, they are concerned that it could get worse.

“My experience with mental health issues is people deal with the crisis at hand really well and it’s when things lighten up and seem to be going back to normal that people fall apart,” said Sherie Ramsgard, a psychiatric nurse practitioner and owner of Whole Mental Wellness clinic in Fayetteville.

Ramsgard said the past few months of widespread quarantine have been a traumatic experience for many, not just those who struggle with anxiety and depression. As a result, Ramsgard said, people in the coming months may start struggling with what is essentially post-traumatic stress syndrome (PTSD).

“We disassociate with the things we can’t help right now and put it in a little box and we just try to get through with the things we can handle on a daily basis,” Ramsgard said.

“But once things lighten up, we start having nightmares, we start having flashbacks, and all of the things we put in a little box starts seeping out because our body has to experience it.”

That fallout from the pandemic could be severe. A recent study from Well Being Trust and the Robert Graham Center for Policy Studies in Family Medicine and Primary Care found that “deaths of despair” — those related to drug or alcohol misuse and suicide — are on the rise.

The study projected that as many as 75,000 lives could be lost in this way as a result of the trauma from the nationwide quarantine.

Paul Joslyn, executive director of the Syracuse-based mental health provider AccessCNY, said the problem may be exacerbated by the fact that many providers may be unable to meet the coming increased need for treatment. The economic toll the virus has taken on the nation’s economy is depleting tax revenues that governments need to fund public and private services, including the work that nonprofits provide. New York officials say the state faces a $13-14 billion deficit for fiscal year

Page 16

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Losing ‘COVID-15’ from previous page

tion control, with food and also with beverages.

“You should have something with zero calories as a filler, such as water,” he said. “You can drink it as much as you can. Drink half of your weight in ounces every day.

Unsweetened tea, you can drink as much as you can. Apple cider vinegar has zero calories. You can take it as much as you can, as it has many benefits for losing weight and more than 100 other benefits.”

Food as reward

2020-2021.

To stem the potential losses, Joslyn is joining Central New York Rep. John Katko, North Country Rep. Elise Stefanik, and others in calling on Congress to increase the funding the federal government allocates to mental health providJacob ers in New York and beyond.

A group of national behavioral and mental health providers that includes the American Foundation for Suicide Prevention, the National Alliance on Mental Illness and the American Psychological Association recently sent a letter to Congress saying as much $38.5 billion may need to be allocated, which is the amount that the organizations expect they could lose in revenue over the next year due to the outbreak. The letter said without this robust investment, behavioral health organizations may not be able to keep their doors open, leaving tens of thousands without access to vital mental health and addiction treatment and care.

The federal government is also being asked to continue the expansion of access to telehealth services, which is medical treatment provided to patients remotely through technology like video-streaming services.

Use of telehealth has skyrocketed during the quarantine, aided in part by regulations that have been eased and the fact that many insurance companies and Medicare are now covering more of these services.

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

Joslyn said one of the silver linings from this outbreak is the increasing number of people who have embraced this kind of technology, which has the potential to broaden access to treatment in a more efficient and cost-effective manner.

Moving forward, Ramsgard recommends that people capitalize on the coping skills they acquired during the pandemic. The statewide PAUSE forced many to get back to the “basics,” Ramsgard said, like paying more attention to sleep, exercise, diet and human connection.

It’s important to stay focused on that short- and long-term.

“Mindfulness, slowing down, being more with nature, not feeling like we have to be on that hamster wheel 24/7 and that we do have to stop sometimes and breathe and just take in the good around us and appreciate those flowers that are blooming and the sunshine,” Ramsgard said.

“I think we get on autopilot so often and we just miss all of the small things in life — what’s that saying?

You’re going to look back and realize that the small things were really the big things.”

Joslyn agrees that staying in contact with others, through whatever medium, is key. Just talking about your struggles with someone else can be therapeutic, he says.

To that end, the state established the New York State Emotional Support Hotline at 1-844-863-9314 where people can schedule a free appointment with a mental health professional.

New Yorkers can also access additional mental health resources at headspace.com/ny. And locally, people can call the National Alliance on Mental Illness (NAMI) Syracuse chapter at 315-487-2085.

It’s easy to say, ‘I’ll start tomorrow’ about losing weight; however, Jill Murphy, personal trainer and co-owner of Mission Fitness in East Syracuse, urges people who need to lose weight to begin right away.

“I think committing to yourself to start now is a great first step,” Murphy said. “Don’t wait until tomorrow, Monday, or after the holiday to begin taking steps to reach your goal. Start now.”

Ironically, some people who want to lose weight use food as their reward for working hard at losing weight. Or they may turn to food for comfort.

“If you feel the need to reward yourself go see a movie, get your nails done, buy a new shirt, or spend money on trying a new healthy recipe,” Murphy said. “Whatever you do, don’t fall into the trap of rewarding yourself with junk food. This will only set you back.”

Instead of treating yourself to an unhealthful food, pick up a produce item you’ve never tried before and research how to prepare it.

Murphy freely acknowledges that losing weight isn’t without cost. It will take time and self-sacrifice, such as getting up earlier to make time to exercise or forgoing a favorite desert if that would throw off a healthful eating plan.

“Take some time to think about what it’s going to take to lose weight and what sacrifices you’ll need to make, and commit in advance to following through with those commitments,” Murphy said.

She’s also a fan of accountability, since that can help keep those losing weight on track and to help analyze why they skip exercise or indulge in a treat. Murphy said that an accountability partner could be a personal trainer, friend, spouse, co-worker or neighbor but that person should be able to follow through.

Overall, she encourages those seeking to lose weight to believe in themselves and to do what they can.

“Don’t focus on what you can’t do, or what you once could do,” she said. “If you focus on what you can do, you’ll do a great job of pushing yourself with the exercise and you’ll enjoy the journey. If you focus on what you can’t do, or what others are doing that you’re not, you’re going to feel discouraged throughout the entire journey. So, focus on what you can do, do that, and I promise you’ll be successful.”

Where have all sick patients gone? The good news for the hospitals is that they are coming back... very slowly.

Patients Wanted Drastic reduction in patient population, layoffs, limited sources of revenue. How hospitals are managing one of the worst crises in the industry and what they are doing to recover from it

By Deborah Jeanne Sergeant

W

hile healthcare providers caring for COVID-19 patients have been busy throughout the pandemic, providers in other areas of hospitals, such as numerous surgeons and related personnel, have been on furlough.

The only surgeries permitted at hospitals during the quarantine were life- or limb-saving procedures or those that are time-dependent for positive outcomes.

As a result, hospitals have lost considerable revenue.

How much they have lost? According to a report released in May by the American Hospital Association, hospitals nationwide will have lost an estimated $202.6 billion from March 1 through June 30, an average of $50.7 billion monthly from direct and indirect effects of COVID-19.

While the related costs include expenses for COVID-19 hospitalizations — additional personal protective equipment and extra support for some hospital employees — a large portion of that loss is from canceled and delayed elective surgery. Ambulatory surgical centers have also experienced losses.

“Our adult medical and surgery patients went down from 600 to 400 patients,” said Ron Lagoe, the director of Hospital Executive Council in Syracuse about the initial drop in patients. He added that as of mid-May the number had increased only to between 520 and 530 among the Syracuse hospitals, way below average.

He said that part of the reason was mandated delays of elective surgery and the rest were “a decline in the medical/surgical census.”

That means a huge loss of income for local health systems, whether from required cancelations or patients forgoing other types of care out of concerns about COVID-19.

“As you can imagine, if you stop what you do that generates income, it creates problems,” said Carla Stebbins, director of health systems management program at Rochester Institute of Technology. “Healthcare still lives on direct billing for procedures and when those aren’t done, there’s no layaway plan. You don’t put deposits down. It creates cashflow issues and income problems like for any business. In healthcare, a lot of the cost related to it are the people.

When you don’t have money coming in, it’s a difficult situation to make payroll.”

She said that shifting personnel, such as nurses going from the surgical team to an acute care team, isn’t as easy as some might think because of specialization in nursing. As a result, hospitals’ typical personnel shortages were exacerbated during the worst part of the pandemic.

Stebbins said that colleagues planned re-opening for elective surgery by working out options that could safely make an in-patient surgery an out-patient surgery to reduce the number of patients using hospital space and resources — especially since if the number of COVID-19

patients surges again, those beds will be needed.

Hospitals have a backlog of cases and surgeons are looking at patients’ cases to prioritize who’s first in line based upon medical needs as outlined by organizations such as The American College of Surgeons.

For hospitals and surgical centers, their economic survival may depend upon efficiently scheduling patients to both meet their healthcare needs and also generate much-needed income.

“Surgery is the economic engine of a hospital,” said Dorothy Urschel, doctor of nursing practice at Daemen College who serves as chief operating officer at Columbia Memorial near Albany. “We had to close some surgery sites and primary care sites.”

She calls the current situation ironic since hospitals must care for the sickest patients while they had to furlough some staff.

“Most hospitals look at their cash positioning and evaluate ‘How do we work together to make sure we’re financially healthy at the end of all this?’” Urschel said.

Early in the outbreak, she didn’t think surgical units would have to be shut down, as even during a bad flu season, surgeries continue. Urschel said that she felt “shock” as state and federal orders suspended elective surgery.

One big key is getting elective surgery patients back to the hospital for care. Many still feel concern over social distancing, especially in a medical setting.

“We’re working with the community at large and developing a ‘marketing campaign’ to make sure patients understand [a hospital] is a safe place to come back to,” Urschel said. “We need to make sure that we present ourselves as a hospital they trust. What we’re looking at is COVID awareness, preparing the patients and staff and the community at large and each patient issue to still deliver a high quality of care.”

Urschel also believes that it’s a good time for hospital administration to evaluate how they can improve their organizations and look at how they can manage resources better, June 2020 •

grow and increase revenue.

Safe place

By mid-May, Oswego Health set June 1 as its planned date to begin offering elective surgery again. In a May 5 press release, Jamie Leszczynski, senior director of communications at Oswego Health, also reminded the public that the emergency room is safe.

“People with warning signs of a heart attack, stroke or other crisis are putting off going to the emergency room or urgent care centers as they’re afraid of catching COVID-19,” she wrote. “That fear can cost lives. Fast treatment in an emergency often raises the odds of survival and can lower the risk of serious complications from an illness or injury. That’s why no one should delay medical care…”

In a similar tone, Gene F. Morreale, president and CEO at Oneida Health Network, noted in a May 7 release that patients should attend to their health issues and that “the Oneida Health Network has experienced a significant decline in routine disease management and preventative screenings as well as lower rates of emergency room visits for acute conditions such as heart attacks, strokes and other acute care illnesses.”

Oneida resumed elective surgeries May 4, an earlier date than other providers in the area because of the low rate of COVID-19 cases at Oneida and the community, according to a statement released that day.

Auburn Community Hospital in Cayuga County was cleared for elective procedures weeks earlier and began offering non-emergency surgery in the week of May 11. Scott Berlucchi, president and CEO, “Remember, during the pandemic plenty of things are on hold — your health should not be one of them,” he stated.

Though cleared to do so, Upstate University Hospital did not offer a press release revealing a set re-start date for elective surgeries and did not respond to requests for information.

St. Joseph’s Hospital began offering elective surgeries on May 11 and Crouse Hospital on May 14.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 17

COVID-19

milk — but infrastructure complicated the possible solution. Store coolers are designed for quarts, half gallons and gallons, not the students’ pints and the food service industry’s bulk containers.

“There are so many variables that have to fall into line like packaging, storage and transportation,” Ammerman said.

Panic buying contributed to a dearth of milk. It may seem sensible that stores could order more cartons and jugs of milk once a shortage seemed imminent; however, stores may not have sufficient storage space for it.

Struggles for producers and consumers

COVID Effects on the Food Supply Chain Bottleneck responsible for recent shortage of milk, meat at the grocery stores

By Deborah Jeanne Sergeant

D

uring the peak of COVID-19 panic buying, many stores’ supply of milk, meat and produce dwindled. Meanwhile, dairy farmers dumped milk and other farms experienced surpluses of their own. The paradox left many consumers scratching their heads — and some feeling ire toward farmers.

Why don’t stores have enough while farmers have too much?

The answer lies in unprecedented bottlenecks in the food supply chain.

“It is a confusing time for a consumer to go into a grocery store and see an empty shelf and farmers are on TV having to dispose of their milk,” said Steve Ammerman New York Farm Bureau public affairs manager. “It doesn’t have anything to do with the farm side of things but the distribution methods.”

It’s illegal for dairies to sell raw milk directly to the public, so consumers can’t simply drive to a nearby dairy to fill a pitcher. The only exception is farms licensed to sell raw milk; however, only a handful of producers statewide possess the hard-to-obtain license.

The cost of building a licensed bottling facility is too high for any dairy still reeling from four years of prices below the cost of production.

Farms with creameries must also market and distribute their milk, enterprises for which farmers may not be prepared.

Farms without their own bottling facilities sell to cooperatives throughout the state. The milk cooperatives decide how much they need for the processing plants, where milk is pasteurized, homogenized and bottled. Ammerman said that because milk normally headed for the food service industry — institutions and restaurants — wasn’t needed during quarantine, farmers had a surplus.

“Those plants are designed for those types of customers and

Page 18

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couldn’t easily pivot and change their processing and package to sell to the grocery store,” Ammerman said. “In turn, there wasn’t a place for all the milk to go and some farmers were directed by their milk cooperative or the plants that they couldn’t pick up the milk.”

Since most farms cannot store, process or bottle their milk, they were often forced to dispose of it at a loss.

While many school districts still offered school lunches for those in need, the number of children receiving a school lunch was lower than those who would normally eat lunch at school. Colleges also sent home resident students. Though restaurants could still operate through take-out, diners didn’t need beverages, as they had those at home. All chefs needed was the milk necessary for cooking.

All of these factors reduced demand for farms supplying these industries. Rerouting that milk to stores may seem like an easy way to keep supplies high — after all, students are someplace drinking

Julie Patterson, the sixth generation on Patterson Dairy Farms in Auburn, said that many people don’t understand that farm operators can’t just reduce supply in response to shifts in the market.

“They keep on giving milk whether we have a place to send it or not,” she said.

The 1,600-cow farm works 2,500 acres. Patterson’s milk goes to Cayuga Marketing, a Aurelius-based cooperative that processes milk and also provides services to yogurt makers Chobani and Fage. Though finding a use for their milk during the crisis hasn’t been a problem, declining milk prices have been.

Meat shortages existed largely because of temporary shut-downs of meat processing plants and transportation issues, not a lack of cows, chickens and pigs. Tapping local farms may seem an easy way to get some meat; however, farmers selling off the farm must sell only whole, halved and quartered animals. A quarter of a beef steer costs around $700 and would supply a family of four with beef for a year. Many families lack freezer space for that much meat or else they must arrange to pool their money with other families and divide the meat they purchase together.

The only legal way for farms to sell smaller amounts to a single buyer — such as just a few packages of ground chuck and a couple ribeye steaks — is to have the meat processed by a USDA-certified processor.

“In New York state, we don’t have major slaughterhouses,” Ammerman said. “A lot of our beef and dairy cows go to Pennsylvania [for slaughter and processing].”

Ammerman said that he has heard anecdotes of meat processors both in New York and outside the

state as being booked. Despite consumer demand, they have reached capacity.

Erin Hull, director of communications and crisis management of the New York Animal Agriculture Coalition, is the owner and operator of Lucky 13 Beef in Tully, where he raises red Angus beef cattle.

“The issue is not that there aren’t animals available or beef available,” Hull said. “The processor is where the hold-up is.”

She explained that many of the larger processors closed because of the pandemic; however, a presidential executive order has enabled them to open. While they play catch-up, consumers have sought local suppliers. Hull’s farm has sold out beef halves and quarters until January 2021. It takes 12 months to raise a steer to the right size to butcher.

“Be patient and seek out a local farmer if you can,” Hull said.

Despite the struggles for producers and consumers, Rick Naczi, CEO of American Dairy Association, said that he sees a few positives by the COVID shake-up to the food supply chain. Though some stores instituted limits to ensure each customer obtained milk, he feels encouraged by the consumer interest in buying milk.

“When people were panic buying, retail sales went up 45%,” he said. “The channel wasn’t ready for that level of buying. It was an imbalance for what that product was made for. Now, we’re buying 15% more dairy products at retail. People are eating at home more.”

Universal home education created opportunities for dairy farmers to generate more interest in farm tour videos so children learn about how milk is made.

Naczi said that the dairy industry needs to reevaluate the supply system, though “you can’t have the infrastructure in place for every possible emergency. I think you’ll see more flexibility in plants to change how they work.”

He has also felt heartened by dairy farmers’ donations, such as Dairy Farmers of America giving away 8,000 gallons of milk at Destiny USA April 22, and many other organizations donating to food banks.

“People have to have faith in our food system that farmers are still working hard,” Ammerman said.

“It’s a supply system still trying to settle and maneuver to adjust to the reality.

“Even though farmers have to go through a lot right now, many are donating to food banks. That’s been very positive and comforting to see, but it’s not a surprise. Farmers jump in and help their neighbors.”

Why Some Products Vanished from the Shelves Mona Golub, vice president of public relations and consumer services for Price Chopper, said that the statewide chain had experienced a few categories of food that ran low during the early part of the pandemic, such as canned vegetables, dried pasta, baking supplies and Golub canned soup;

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

however, that was likely because of panic buying and also because of unanticipated shifts in the market and weather.

“Soup generally falls off by the time we get to March,” she said.

“When kids are home more, more meals are made at home and the weather stays cool, then soup is popular.”

The surge in baking — typically a popular activity during the fall and winter — also abruptly lowered supplies in that aisle as consumers quarantined at home wanted homemade treats and familiar rituals.

“We’ve been resourceful relative

to maintaining the food supply, calling upon a vast network of distribution and tapping into the food service supply chain,” Golub said.

For example, purchasing bulk meat that would have gone into the restaurant market and repackaging it in consumer-friendly sizes enabled Price Chopper to keep up its stock closer to normal levels.

As of mid-May, Golub said that Price Chopper’s stock still wasn’t at 100% of what it normally carries, but Golub said part of the reason is that manufacturers are focused on making more of their core products.

Summer Fun in Isolation

The arts, entertainment and recreation sector is still closed but there are many ways to have fun early this summer

By Deborah Jeanne Sergeant

A

lthough businesses are opening, a sufficient increase in new COVID-19 cases may cause New York to close or limit how they operate. Although arts, entertainment and recreation represents the last category of business types slated to re-open, you can still find fun ways to get out this summer to have fit fun.

Retail – curbside pickup and agriculture, forestry, fishing and hunting are among the first categories opening.

Stop at a favorite local restaurant or store to pick up a healthful lunch to take your family on a picnic, whether at home or at a park. Ramp up the fun by selecting a theme like “New York-grown picnic” and choosing only items made in New York. Many restaurants that didn’t specialize in take-out pre-pandemic

have adjusted to current times and may likely continue offering take-out.

Bring along a Frisbee or other lawn game to spend more time outdoors.

Visit a produce farm for you-pick produce. Look up a farm near you at www.pickyourown.org/nycentral. htm, which maintains an updated list of farms in the region. Especially because of the pandemic, it’s important to call first so you can abide by the farm’s rules. For example, the farm may limit the number of pickers at a time or require that you use their containers. Some of the farm’s amenities like a children’s play area may not be available, so ask if you’re unsure. If you’re not up for picking, many farms on the site and other farmers operate farm stands providing fresh produce. Try a new recipe with your produce goodies at home.

Grab your pole and fishing

license to try your angling skills in the region’s waterways. The DEC’s website (www.dec.ny.gov/outdoor/ fishing.html) shows where to go and offers online fishing licenses. Fishing licenses are also available over the phone at 866-933-2257.

Visit a park. Whether you want to select a location you haven’t hiked before or want to revisit an old favorite, many of the state’s parks (https://parks.ny.gov/parks) have remained open. Battle Island State Park (315-593-3408) features an 18-hold golf course and also geocaching. Clark Reservation Park (315-492-1756) boasts hiking, fishing and picnic pavilions. Its eclectic mix of environments—from meadows to wetlands to rocky cliffs—make its plant and bird life quite diverse.

It’s still advisable to maintain social distancing of six feet and to wear

masks when that’s not possible. The parks may not have certain features and amenities open, so check the park’s website or call before heading out.

Play with your children at home.

Indulge in the fun of a water balloon fight, sidewalk chalk drawing, or tossing a ball around. Build a goofy obstacle course or a disc golf course (use buckets as goals) and challenge them. Hang out with them in their kiddie pool. If your children are tired of your current outdoor games, they may have outgrown them or may have discovered parts are broken or missing. Invest in a few new ones, like badminton, croquet, lawn darts, lawn bowling or tetherball (great for small yards and small families).

It’s good, fit fun that gets everyone moving.

Reach nearly 100,000 health-conscious people in Central New York.

Advertise with In Good Health, CNY’s Healthcare Newspaper editor@cnyhealth.com June 2020 •

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Page 19

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Fitness in the Finger Lakes New free hiking challenge offers incentives for people to get active on the trails this summer

By Kyra Mancine

T

o encourage hiking on the more than 1,000 miles of trails across New York state this season, the Finger Lakes Trail Conference (FLT) has launched the FLT50 Challenge.

FLT is a nonprofit based in Mount Morris, Livingston County.

Walk, run or hike a total of 50 miles on FLT’s expansive trail system and you’ll receive a patch, certificate and sticker and be entered into monthly drawings for prizes. For you hiking overachievers out there, if you up your mileage to 50 miles for three months over the course of the year, you can earn a hat. Tag your progress on social media and you might even be highlighted on the FLT’s website and social media sites.

“So many people have discovered the benefits of hiking and walking and being outdoors during this crisis — it’s been one of the few things we can still do,” said Christy Post, director of marketing and communications at FLT. “And I think that’s been great for people — and for families — especially now that the weather is getting nice. I know my kids and I are getting out more together, and I see a lot more people and families out on the trails than I used to.”

If you’re concerned about maintaining social distancing outside, this is the perfect pursuit. “Activities that allow physical distancing will be the

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new normal for most of the summer, and trails give people the space they need to be safe,” said Post. “Our hope is that this challenge brings people and families together for healthy activity — with appropriate social distance — and brings us all together virtually with shared pictures and adventures on the trails.”

Open to all ages, participation in the FLT50 is easy. Simply pick a FLT trail, complete your miles and submit your tally once you’re finished. Largely built and maintained by volunteers, FLT’s numerous trails run from the Pennsylvania-New York border in Allegany State Park to the Long Path in the Catskill Forest Preserve and includes branch trails to Niagara Falls, the Genesee River valley, the Great Eastern Trail south of Corning, the central Finger Lakes and the Syracuse region. Founded in 1962, FLT’s mission is “to build, protect, enhance, and promote a continuous footpath across New York State. Forever!”

Organizers say this is the perfect opportunity to get outdoors. They cite a RunRepeat study of over 12,000 people from 139 countries showing that during March people who normally exercised once or twice a week increased exercise frequency by 88%.

Even moderate athletes who normally exercised three times a week increased their frequency by 38%.

“This challenge came at exactly the right moment,” according to one FLT50 challenge participant. “We’d found ourselves moping about the house, putting on pounds and full of self-pity for backpacking trips canceled. I had no idea such incredible, sweeping vistas were less than 15 miles from home. I felt entirely transformed. I can’t wait to get out there again and rack up those miles!”

You can start the challenge at any time, and miles must be completed and submitted by the end of 2020.

If you want to join the FLT50 challenge, visit https://fingerlakestrail.org for more details, including maps and a mileage tracker you can download.

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

CA-00087634

Best Summer Produce for Diabetics Doctor: ‘[Diabetes] can be basically reversed with a healthy lifestyle’

By Deborah Jeanne Sergeant

S

ummer produce season is in full swing; it’s a great time to eat plenty local, fresh foods available at pick-your-own farms, farm stands and markets, and possibly at a home garden.

These foods can be helpful for diabetics in improving their blood sugar levels because of their low glycemic index status, among other benefits. “[Diabetes] can be basically reversed with a healthy lifestyle,” says physician Az Tahir, who practices holistic medicine in Rochester.

He says that in addition to exercise and stress reduction — both essential for a healthy lifestyle — eating plenty of produce “is part of the protocol for helping reverse effects of diabetes.”

The glycemic index is based on a food’s carbohydrate content and how it affects blood glucose levels after a meal. According to Diabetes Self-Management, “a glycemic index of 55 or lower is considered low, a

glycemic index from 56 to 69 is considered intermediate, and a glycemic index of 70 or higher is considered high.”

Most vegetables and fruits are within the range of 0 to 55.

The person’s age, gender, weight, number of active minutes per week and general health affect the ideal glycemic load that their diet can bear, as well as how the produce is prepared. In general, the lower the glycemic index, the better. That’s why incorporating produce makes sense. For their volume, many fruits and vegetables are low in carbohydrates. They are also rich in vitamins, minerals and naturally-occurring compounds that improve health in many ways.

“It is best to avoid or limit items with added sugar, fruit juices, canned fruits with syrup and dried fruits as these have more sugar and less fiber than fruits by themselves,” said Lau-

rel Sterling, registered dietitian with Carlson Labs in Canastota. “Lower glycemic index fruits like apples, berries, pears, kiwi and apricots are better choices. Fruits and vegetables with more fiber and less natural sugars in them are better choices for a diabetic.”

She listed as good vegetables choices broccoli, asparagus, cauliflower, green beans, peppers and lettuce.

“Limit higher sugary fruits like bananas and pineapple and vegetables like carrots and corn,” Sterling said. “If you do choose to have these, make sure to have them in a meal with healthy fats.”

For example, cooking in extra-virgin olive oil or another plantbased fat or serving veggies with a fatty fish like salmon can incorporate beneficial fats into a meal. Fat from red meat, chicken skin or butter are examples of not-so-healthful fat and

should be used more sparingly.

Eating a higher glycemic index fruit or vegetable with a healthful fat “will slow the sugar release into the body and not cause a sugar spike,” Sterling explained. “This is when they refer to glycemic load versus glycemic index. Glycemic load is when foods are combined together and a number value is put to it. The lower number the GI and GL is, the better it is for you.”

The portion size also makes a difference in glycemic load per meal.

Dietary recommendations can vary depending up on many health, age and co-existing condition factors.

Any food can be part of a healthful diet, though diabetics need to be especially careful about balancing what they eat and how they exercise under the guidance of their healthcare providers.

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June 2020 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 21

Fitness room at Elements of Central New York, part of a new inpatient clinic for substance disorder patients that recently open in Liverpool.

Inpatient Clinic for Substance Use Disorders Opens in Syracuse 75-bed residential program will offer three phrases of recovery in one facility

By Payne Horning

T

he opioid epidemic has reached all corners of New York state and Central New York, but the amount of inpatient facilities to help people recover from their addiction is not as widespread.

This shortage can force those who are trying to recover in underserved areas of the state to travel to other parts of New York in order to find these types of services.

That’s the case in Central New York, too, says Jeremy Klemanski, director of Helio Health, a nonprofit health care organization that works with people struggling with substance abuse and mental health disorders. Helio Health offered some acute inpatient detox and rehabilitation services, however, Klemanski

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says it was not enough to meet the growing demand.

“There’s a lot of anecdotal evidence experience we have that shows that leaving the area is generally not what’s best for people,” Klemanski said. “It’s harder to reunite with their family or reconnect with their support structure if they can’t see them. They can’t make those easy transitions to living back at home or to reuniting with a loved one. We wanted to minimize that.”

So, Helio Health partnered with Onondaga County and the New York State Office of Addictions Services and Supports to address the problem.

Together, they opened Elements of Central New York, a new residential addiction treatment facility at 4567

APRIL 2020 • ISSUE 244

CORONAVIRUS Getting on with our lives in this new age

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Frontline

Beware of Coronavirus Scams P. 17

Autismn: Why Are Incidence Rates So High?

RECORD NUMBER OF PEDESTRIAN DEATHS IN U.S.

Local experts discuss the dramatic increase in cases of autism in the U.S.

The role of nursing has taken on even greater significance, as nurses and other healthcare providers are frontline responders in the battle against COVID-19.

As nurses celebrate their month in May, we profile four of them.

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That’s the number of times most people touch their faces in an hour. We have tips to reduce that.

Study estimates 6,590 pedestrian deaths in 2019, an increase of 5% over previous years

BETTER HEALTH IN AUBURN

The Amazing Benefits of Olive Oil

P. 12

Physician Paul Fu is Auburn Community Hospital’s new deputy chief medical officer. He What type of camp shouldwants to improve you choose if your child quality of care his has allergies or asthma? hospital offers.

Summer Camp

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More People in the Region Seek Animal Interactions

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MAY 2020 • ISSUE 245

On the

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Crossroads Park Drive in Liverpool.

The clinic boasts 55 stabilization and rehabilitation beds and 20 reintegration apartments.

Elements of Central New York was specially designed to provide patients treatment for almost every phase of their recovery.

In the stabilization phase, patients receive integrated medical care while they recover from withdrawal symptoms; in the rehabilitation phase, they are treated with medication, therapy and healthy living education while working on building long-term resiliency; and in the reintegration phase, patients transition from a structured-treatment setting to independent living on-site while getting assistance in setting up

housing, work, and supportive social structures for when they are eventually discharged.

“One of the things that’s a huge risk factor for people in recovery from substance use disorder is going back into the community when they’re still not comfortable that everything is quite the way they wanted — their medication isn’t having the full effect they need, they are still adjusting dosages, or they are still have having anxiety about their work or home life situation,” Klemanski said. “We just want to be able to make that transition in a comfortable way for folks so that we try to minimize the risk of a relapse and help them become re-stabilized.”

Helio Health has started treating patients in the 44,000-sq.-ft. facility, which originally was an old office building and vacant land. Klemanski says they complete gutted to the building to its steel and concrete frame and added a new roof, plumbing, and parking lot ahead of the Feb. 11 ribbon cutting. The total cost was $14 million. New York state footed the bill and will continue to help fund the clinic with an annual $1.1 million allocation.

Elements of Central New York is the latest step the state has taken in what Gov. Andrew Cuomo calls an aggressive, multi-pronged effort to address the opioid epidemic. His administration says efforts like these may be helping to turn the tide in the opioid crisis.

It was announced late last year that opioid overdose deaths among New York state residents outside New York City declined 15.9% in 2018 compared to 2017, the first decrease in 10 years.

“The addiction epidemic has been a terrible scourge on our communities, but thanks to the hard work of the state and organizations like Elements of Central New York, 2018 saw the first decline in overdose deaths in New York in a decade,” Cuomo said in a press release. “We’re not letting up the fight against addiction and with the opening of this new center we are continuing to lead the way by expanding services throughout the state to try to reach all those in need of treatment and support.”

The New Normal: Face Masks, Social Stigma P.11

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Most Upstate New Yorkers Don’t Recognize Signs of Stroke Study shows only one third of Upstate residents recognize signs

O

nly one-third of adults in New York state say they can recognize the signs of a stroke, according to a review of self-reported data by Excellus BlueCross BlueShield.

That’s bad news since every 40 seconds someone in the United States has a stroke, according to the American Heart Association. Knowing when someone is exhibiting the symptoms of a stroke can lead to quicker treatment and a lower risk of disability or death.

A stroke occurs when a blood vessel supplying oxygen and nutrients to the brain becomes blocked with a blood clot (ischemic stroke) or when a blood vessel bursts, causing bleeding within or around the brain (hemorrhagic stroke).

The brain is deprived of oxygen, and brain cells die within minutes.

The body cannot replace damaged brain cells, so the effects of a stroke are often permanent.

“A stroke is a brain attack, and damage can increase with every

minute that treatment is delayed,” said physician Nicholas Massa, medical director at Excellus BCBS. “The acronym F-A-S-T is an easy way to remember what to look for and what to do if you suspect someone has had a stroke.”

• F = Face. Ask the person to smile. Does one side of the face droop?

• A = Arm. Ask the person to raise both arms. Is one arm drifting down or appearing weak?

• S = Speech. Ask the person to repeat a simple phrase. Is speech slurred or confused?

• T= Time. Time lost is brain lost, so call 9-1-1 right away if you detect any signs of stroke.

Stroke is the fifth leading cause of death in the United States after heart disease, cancer, accidents and chronic lower respiratory disease.

About 6,000 New Yorkers die each year from a stroke. Risk factors include high blood pressure, high cholesterol, diabetes, tobacco use and obesity. Among adults in Upstate

New York, more African Americans and Hispanic Americans self-report experiencing a stroke compared with those who self-identify as White.

“Anyone with any of the risk factors for stroke should speak with their doctor about medical interventions or lifestyle changes to reduce their risk,” said Massa. “And everyone should know the acronym F-A-S-T, so they can recognize when someone is showing signs of a stroke and can summon medical help immediately.”

Excellus BCBS created a free and downloadable educational poster, “The Sudden Signs of Stroke,” available at https://tinyurl.com/ y9jq46wt .

The U.S. Centers for Disease Control and Prevention designated May as National Stroke Awareness Month. Learn more at www.cdc.gov/ stroke/communications_kit.htm Submitted by Excellus BlueCross BlueShield

Excellus Selects Nine Nonprofits for Its Community Health Awards Excellus BlueCross BlueShield chose nine organizations from among more than 40 Central New York nonprofits that submitted applications for the Community Health Awards the company made available in Upstate New York earlier this year.

Each recipient was awarded up to $4,000 allocated by the company to help fund health and wellness programs in the company’s five-county Central New York region.

Through a competitive application process, Excellus BlueCross BlueShield’s Community Health Awards support programs that have clear goals to improve the health or health care of a specific population.

Awards focus on improving the health status of the community, reducing the incidence of specific diseases, promoting health education and enhancing overall wellness. Winning organizations are selected based on the proposed program’s scope of need, goals, and the number of people expected to benefit from it.

The nine nonprofit organizations selected are: • Auburn Memorial Medical Services, to purchase lead testing kits for two pediatric practices in Auburn. The lead testing kits will increase the number of children being tested for lead exposure and poisoning in Cayuga County.

• Brady Faith Center, Syracuse, for the Southside Wellness Ambassador program, which provides wellness education and meals on Syracuse’s Southside. Wellness ambassadors engage neighbors of Brady Farm (located on Ford Avenue) to increase their consumption of fresh fruits and vegetables through delivering food to families and then having them join online to take part

in a cooking session with the delivered ingredients.

• Loretto/PACE CNY, Syracuse, to provide multisensory interventions such as auto-locking glider chairs, ambient lighting, play therapy, UV light therapy and add a large mobile raised garden bed component to Loretto’s multisensory environment for individuals who have dementia, cognitive impairment and other special needs. In collaboration with Cornell Cooperative Extension’s Master Gardeners, Loretto will introduce horticulture therapy to enhance quality of life among participants.

• Onondaga County Health Department, Syracuse, to purchase a blood lead testing analyzer device and testing supplies that will be used by Lead Poisoning Prevention Program staff in an Onondaga County Health Department clinic that serves high-risk children.

• REACH CNY, Syracuse, to purchase toddler mattresses and bed frames as an incentive for high-risk women who are parenting 1- to 3-year-old toddlers in Oswego County to participate in Community Health Worker programming. The programming will screen for and provide education and referrals to basic health services, including adult primary care, pediatrician/well-child visits, dental care and family planning services.

• Rescue Mission, Syracuse, to purchase 50 pairs of puncture-resistant gloves used for sharps disposal and also to purchase and install an automated external defibrillator at the Rescue Mission’s new Runaway and Homeless Youth Shelter.

• Seven Valleys Health Coalition, Cortland, to revamp

the organization’s “Get Cortland Cooking Healthy” classes, a series of five free cooking classes that are open to the public. The classes teach residents how to access and prepare healthy foods and focus on preparing healthy, tasty and easy recipes that incorporate produce.

• Help Me Grow Onondaga/ United Way of Central New York, Syracuse, will offer a series of five developmental screening and education events for parents and caregivers via online platforms and at public libraries. Participants of the Books, Balls and Blocks events will receive age appropriate “Help Me Grow” tote bags that will be delivered to their doors or in person. They will feature developmentally appropriate toys, along with directions and ideas for parents to continue playing with their children in their home environments.

• The Upstate Foundation, Syracuse, to provide medications, dental and eye care, walkers, socks, boots, personal care items and other emergent supplies for Upstate Medical University’s “Housecalls for the Homeless” street medicine program.

The program delivers medical, psychiatric and addiction care safety net services for men and women experiencing homelessness in Syracuse.

“The company’s Community Health Awards demonstrate a corporate commitment to supporting local organizations that share our mission as a nonprofit health plan,” said Jim Reed, regional president, Excellus BlueCross BlueShield. “These awards given out earlier this year complement our existing grants and sponsorships with agencies that work to enhance quality of life, including health status, in upstate New York.”

June 2020 •

New York Is 2020’s Worst State for Doctors: Study

W

ith doctors on the front lines against the threat of coronavirus, National Doctors’ Day coming up on March 30 and “physician” being the highest-paid job of 2019, The personal-finance website WalletHub released in March its report on 2020’s Best & Worst States for Doctors as well as accompanying videos.

According to the study, New York is the worst state in which doctors can practice.

To identify the best states for those in the business of saving lives, WalletHub compared the 50 states and the District of Columbia across 19 key metrics.

The data set ranges from average annual wage of physicians to hospitals per capita to quality of public hospital system.

Practicing in New York (1=Best, 25=Avg.): • 50th – Average annual wage of physicians (adjusted for cost of living) • 45th – Average monthly starting salary of physicians (adjusted for cost of living) • 51st – Hospitals per capita • 28th – Projected percentage of population aged 65 and older by 2030 • 46th – Projected physicians per capita by 2026 • 51st – Malpractice award payout amount per capita • 39th – Annual malpractice liability insurance rate Rhode Island, Connecticut, Massachusetts and Alaska are also listed at the bottom of the list as worst states for medical doctors. The best states for doctors?

Montana tops the list, followed

by Wisconsin, Idaho, North Dakota and Minnesota.

For the full report, please visit: wallethub.com/edu/best-andworst-states-for-doctors/11376

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

Visit www.ssa.gov/benefits/ medicare to apply for Medicare and find other important information. If you’re eligible for Medicare at age 65, your initial enrollment period begins three months before your 65th birthday and ends three months after that birthday.

We’ve organized our Online Services webpage into four popular categories for easy navigation: • Review Your Information. You can access your secure, personal information and earnings history to make sure everything is correct. You can even print statements with ease.

• Apply for Benefits. You can apply for retirement, disability, and Medicare benefits without having to visit a field office.

• Manage Your Account. You can change your direct deposit information and your address online.

• Find Help and Answers. We’ve answered your most frequently asked questions, and provided links to publications and other informational websites.

Let your family and friends know they can do much of their business with us online at www.ssa.gov.

costs be reviewed and, if so, how often?

A: If you get the Extra Help, Social Security may contact you to review your status. This reassessment will ensure you remain eligible for Extra Help and receive all the benefits you deserve. Annually, usually at the end of August, we may send you a form to complete: Social Security Administration Review of Your Eligibility for Extra Help. You will have 30 days to complete and return this form. Any necessary adjustments to the Extra Help will be effective in January of the following year. Go to www.socialsecurity.gov/prescriptionhelp for more information.

Q: I went back to work after retiring, but now the company I work for is downsizing. I’ll be receiving unemployment benefits in a few weeks. Will this affect my retirement benefits?

A: When it comes to retirement benefits, Social Security does not count unemployment as earnings, so your retirement benefits will not be affected. However, any income you receive from Social Security may reduce your unemployment benefits.

Contact your state unemployment office for information on how your state applies the reduction to your unemployment compensation.

By Jim Miller

What Older Diabetics Should Know About Coronavirus Dear Savvy Senior, My husband and I are both in our late 60s and have diabetes. We would like to find out if our diabetes increases our risk of getting the coronavirus.

Dear Concerned, Currently, there’s not enough data to show that people with diabetes are more likely to get COVID-19, the disease caused by the coronavirus, than the general population.

But the problem for diabetics is, if you do happen to contract the virus, your chance of developing serious complications are much higher. This is especially true if your diabetes isn’t well-controlled. Here’s what you should know.

Diabetic Risks Health data is showing that about 25% of people who go to the hospital with severe COVID-19 infections have diabetes. One reason is that high blood sugar weakens the immune system and makes it less able to fight off infections. Your risk of severe coronavirus infection is even higher if you also have another condition, like heart or lung disease.

If you do get COVID-19, the infection could also put you at greater risk for diabetes complications like diabetic ketoacidosis (DKA), which happens when high levels of acids called ketones build up in your blood.

Some people who catch the new coronavirus have a dangerous bodywide response to it, called sepsis. To treat sepsis, doctors need to manage your body’s fluid and electrolyte levels. DKA causes you to lose electrolytes, which can make sepsis harder to control.

How to Avoid COVID-19 The best way to avoid getting sick is to stay home as much as you can. If you have to go out, keep at least 6 feet away from other people.

And every time you come back from the supermarket, pharmacy or another public place, wash your hands with warm water and soap for at least 20 seconds.

Also wash your hands before you give yourself a finger stick or insulin shot. Clean each site first with soap and water or rubbing alcohol.

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house should wash their hands often, especially before they cook for the family. Don’t share any utensils or other personal items. And if anyone in your house is sick, they should stay in their own room, as far as possible from you.

The CDC also recommends that you stock up on medications and diabetes testing supplies to last for at least a month. The same goes for grocery supplies and other household necessities.

Also know that Medicare is now covering the cost of telehealth visits, so if you have questions for your doctor, you can ask by video chat or phone instead of going into the office.

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If You Get Sick The most common symptoms of COVID-19 are a dry cough, fever or shortness of breath. If you develop any symptoms that are concerning, call your doctor about getting tested.

If you find that you have contracted COVID-19, the first level of care is to stay home and check your blood sugar more often than usual and check your ketones too.

COVID-19 can reduce your appetite and cause you to eat less, which could affect your levels. You also need more fluids than usual when you’re sick, so keep water close by, and drink it often.

You should also know that many over-the-counter medicines that relieve virus symptoms like fever or cough can affect your blood sugar levels one way or the other. So, before you take anything check with your doctor.

And be aware that if you start experiencing severe shortness of breath, high levels of ketones or DKA symptoms like severe weakness, body aches, vomiting or belly pain, you need to see your doctor or get to an emergency room right away.

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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H ealth News Founding Partner at HOACNY Receives Prominent Designation Dr. Jeffrey J. Kirshner is awarded fellowship designation from the American Society of Clinical Oncology

H

ematology-Oncology Associates of CNY, founded in 1982, has announced one of its founding partners and principal investigators for its clinical research department, physician Jeffrey J. Kirshner, will be honored by receiving the prominent distinction of fellow of the American Society of Clinical Oncology (ASCO) at its annual meeting in June.

Over 300 fellowships have been awarded over the years. Kirshner is the first physician in Central New York to earn the designation.

Kirshner serves on ASCO expert panels and committees to provide guidelines for the management of cancer patients used by oncologists

Upstate’s department of anesthesiology has new chairwoman Physician Xiuli Zhang has been appointed chairwoman of the department of at SUNY Upstate effective May 11. The appointment was announced by college of medicine Dean Lawrence Chin. Zhang has served as interim chairman of anesthesiology since August 2019.

“I am pleased and honored to have Dr. Zhang lead the department of anesthesiology,” Chin said.

“The department has benefited greatly from her interim service and we look forward to her continued leadership as chair.”

AccordZhang ing to a news release from Upstate, over the last six months as interim chairwoman, Zhang worked ceaselessly to ensure that clinical operations continued without interruption while maintaining standards of excellence. During her interim role, she recruited five physicians who will join the faculty this year. As interim chairwoman, she has maintained close collaborative relationships with faculty, administration and surgical and nursing teams.

“Throughout my time as interim chair, I have been struck by my encounters with many hardworking, passionate colleagues who, across disciplines and specialties, are dedicated to working together for the greater good,” Zhang said. “They have motivated and inspired me, and my ambition to lead our department into an era of growth and success is greater than ever.”

In addition to her post as chairwoman of anesthesiology, Zhang has served as chief officer of the day since 2009 in addition to chief of anPage 26

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esthesia service schedule since 2010.

Zhang joined Upstate in 2002.

She earned her medical degree from Qingdao Medical College, China. After coming to the United States, she became a research fellow in the field of immunology at Tufts University School of Medicine. She completed an internship in general surgery at Brooklyn Hospital Center prior to entering anesthesiology residency at Upstate Medical University, where she served as chief resident (2004 to 2005).

After completing her training as chief resident, Zhang continued at Upstate as a faculty member. She has been recognized several times over as Attending of the Year and was recognized with Upstate Gold Standard Award in 2012.

Loretto announces two promotions Loretto recently announced the promotion of two of its professionals.

• Courtney Lyon has been promoted to the role of administrator for Loretto Health & Rehabilitation in Syracuse.

Formerly the assistant administrator of Loretto Health & Rehabilitation, Lyon holds a bachelor’s degree of Lyon biological science from Le Moyne College and a master’s degree in health care administration from Utica College.

She has been with Loretto since 2015, with roles in finance, operations, and most recently the assistant administrator at Loretto Health & Rehabilitation.

• Jack Pease, former administrator of Loretto Health & Rehabilitation has been promoted to administrator for The Nottingham Residential

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

around the world.

The Fellow of the American Society of Clinical Oncology (FASCO) distinction recognizes members for their extraordinary volunteer service, dedication and commitment to ASCO. Recipients have carried out efforts that benefit ASCO, the specialty of oncology, and most importantly, the patients whom they serve.

Once conferred, the fellow status is a lifetime recognition. The award was launched in 2007 and was formerly called the ASCO Statesman Award. This distinction honors members for their extraordinary volunteer service and dedication to the American Society of Clinical Oncology and the Association for Clinical Oncology Health Care Facility in Jamesville.

Pease has been with Loretto since 2012 and served as administrator at several Loretto locations. He is a certified nursing home Pease administrator and is a fellow with American College of Health Care Administrators. He holds a bachelor’s degree in economics.

St Joe’s gets ‘A’ in Leapfrog Hospital Safety Grade St. Joseph’s Health Hospital received an ‘A’ in the spring 2020 Leapfrog Hospital Safety Grade. It is the only hospital in Central New York to receive this designation, a third consecutive grade ‘A’ safety grade, according to the hospital.

The Leapfrog Group is a nonprofit watchdog organization that serves as a voice for health care purchasers, using their collective influence to foster positive change in U.S. health care.

Surveyed hospitals are assessed based on three of Leapfrog’s most important patient safety standards: infections, hand hygiene, and ICU physician staffing. The safety grade assigns an ‘A’, ‘B’, ‘C’, ‘D’ or ‘F’ grade to hospitals across the country based on their performance in preventing medical errors, injuries, accidents, infections and other harms to patients in their care “Safety has always been part of St. Joseph’s Health’s culture — from frequent hand washing, wearing proper PPE to rigorous cleanings of exam, surgical and patient rooms,” said Leslie Paul Luke, president and CEO at St. Joseph’s Health. “This

(collectively ASCO). The award was designed to honor ASCO’s most active and valuable members.

Hematology-Oncology Associates has maintained a robust clinical research department for over 35 years.

For more information about HOA’s clinical research department, call 315-472-7504 or visit them on the web at www.hoacny.com.

The American Society of Clinical Oncology (ASCO) is the world’s leading professional organization representing physicians who care for people with cancer. With more than 45,000 members, ASCO is committed to improving cancer care through scientific meetings, educational programs and peer-reviewed journals.

For information about ASCO, visit www.asco.org.

rating demonstrates the success of our efforts to be the safest and most reliable hospital in the region. Patient safety is critically important for all hospitals, especially during the current Coronavirus pandemic. To be named among the safest hospitals in the country serves as firm reassurance to our patients and the community that they should feel comfortable coming to us for care.”

Developed under the guidance of a national expert panel, the Leapfrog Hospital Safety Grade uses 28 measures of publicly available hospital safety data to assign grades to more than 2,600 U.S. acute-care hospitals twice per year. The Hospital Safety Grade’s methodology is peer-reviewed and fully transparent, and the results are free to the public.

New orthopedic surgeon joins Oswego Health Oswego Health welcomes orthopedic surgeon Kamaljeet Singh Banga to its medical staff.

He joins the hospital’s Center for Orthopedic Care team where he will practice with physicians John Ayres and Michael Diaz.

Banga has Banga been practicing orthopedic care for the past 18 years, with his most recent position being at Auburn Community Hospital.

He earned his medical degree from Punjab University in Chandigarh, India. He completed his two residencies in orthopedics at the Army Command Hospital in Chandimandir, India, and McMaster University, Canada. In addition, Banga completed two fellowships in upper extremity and sports medicine post Canadian residency. Along with performing surgeries, he serves as a

H ealth News clinical assistant professor of orthopedic surgery at Upstate Medical University.

“I chose to work for Oswego Health not only because of their reputation and the level of service provided, but because of this community,” said Banga. “Specializing in sport injuries naturally draws me to want to care for patients within communities that have robust athletic programs not only at the collegiate level but any level. I just like having the opportunity to make a difference here in Oswego County.”

Advocates for Upstate has new administrative coordinator Debra Gamble has joined Advocates for Upstate Medical University as administrative coordinator. In this position, she reports to the Advocates’ board of directors and plays a critical role in the organization’s successful operation. She replaces Jonathan Adler who retired in May. Gamble has experience in operations and programmatic financial management, research and contract funding oversight, program start-up,

Crouse Health’s Emergency Department Recognized American College of Emergency Physicians (ACEP) recognizes Crouse’ ED for Improving outcomes of opioids, sepsis and chest pain

T

he American College of Emergency Physicians (ACEP) has recognized Crouse Health’s Pomeroy Emergency Services Department to its Emergency Quality Network (E-QUAL) Honor Roll for leading the way for how the nation cares for emergency services patients.

Just 192 emergency departments across the U.S. — out of 5,200 — were named to the 2019 E-QUAL Honor Roll, which is based on a learning collaborative that includes virtual quality improvement activities and sharing of clinical performance data.

Crouse was recognized for: • improving outcomes for sepsis patients; • reducing avoidable hospitalizations for patients with low-risk chest pain; • reducing opioid-associated harm through safer prescribing and the implementation of evidence-based interventions.

Crouse was the only emergency department in Upstate New York that made the 2019 honor roll.

“This recognition reflects our team’s ongoing focus on improving clinical outcomes and the overall patient experience for our emergency services patients,” says physician David Mason, medical director of emergency services for Crouse Health. “It is gratifying to see the work we have done in the areas of sepsis, chest pain and opioid intervention receive national recognition,” “Through collaboration and innovation, the emergency departments that participate in E-QUAL are transforming emergency medicine and advancing how we care for millions of people,” said physician William Jaquis, president of ACEP. “The 2019 E-QUAL Honor Roll awardees are the shining example for how emergency departments can lead the way in practice transformation and quality improvements.”

Crouse’s Pomeroy Emergency Services Department treated more than 63,000 patients in 2019. The hospital’s door-to-cardiac treatment times are among the lowest on the region and the organization is a New York state and DNV Healthcare-designated Comprehensive Stroke Center.

management and event coordination and marketing and public relations.

She is experienced in database development, management and reporting and software systems.

“I am excited to use my experience and skills for this committed group of volunteers dedicated to enhance the quality of patient, family and community health and to advance knowledge in medical education, through fund raising and support,” said Gamble.

Gamble comes to Advocates for Upstate most recently from Syracuse University after 10 years of service.

She has held healthcare administrative positions in Houston, Texas, working at Vanguard Urologic Institute, Baylor College of Medicine, the University of Texas M.D. Anderson Cancer Center, and Rice University.

A resident of Syracuse, she holds a bachelor’s degree in psychology from SUNY Oswego and an associate degree in medical office science from Jefferson Community College, Watertown.

Advocates for Upstate is a 501(c)3 organization that supports healthcare and scholarship through fundraising and service.

The Center for Wound Healing at Oswego recognized as center of excellence

Oneida Health Rehabilitation and Extended Care remains COVID-19 free

ture is asked to remain home as a safety precaution until his or her symptoms subside.

“Our employees recognized from the onset the importance of being diligent about their own health and practicing social distancing in order to keep COVID-19 out of our facility,” Scerbo said. “We also have a distinct advantage by being connected to the hospital. It has allowed us to adhere to strict infection control strategies and access to protective personal equipment that stand-alone nursing homes may have difficulty attaining once the pandemic began.”

Oneida Health skilled nursing employees routinely wear facemasks, face shields and gloves.

During the start of the pandemic, nursing homes were required by executive order to accept any resident even if they tested positive for COVID-19 prior to admission. To maintain a COVID-19-free environment, Oneida Health established an isolation unit on its second floor with dedicated staff to test and monitor new residents for symptoms prior to introducing them to resident areas.

On May 10, the executive order was reversed and skilled nursing facilities are no longer required or permitted to accept COVID-19 positive residents.

Scerbo said Oneida Health plans to continue to use the isolation unit for the indefinite future as a means of continued precaution when accepting new residents.

“With the current rate of false negative testing and asymptomatic COVID-19-positive patients, this proactive measure will continue to provide one more layer for keeping COVID-19 from being introduced to our resident community,” Scerbo said.

Recently, Oneida Health agreed to participate in a voluntary COVID-19 testing of its skilled nursing facility as part of a collaborative effort lead by Madison County and New York state health officials.

The initiative was a result of growing concern related to the recent increase in the number of both COVID-19 positives and deaths occurring in skilled nursing facilities throughout the state.

Oneida Health, which has a 160-bed extended care and shortterm rehabilitation center in Oneida, recently announced that its 134 residents and 207 staff members all tested negative for COVID-19.

“We couldn’t be more proud of the negative testing result for our entire facility,” said Fred Scerbo, Oneida Health Rehabilitation Center and Extended Care administrator. “To have no residents or staff test positive and remain a COVID-19-free facility during the pandemic is a testament of our commitment to the safety and care of our residents.”

Early in March, Oneida Health activated a strict no-visitor response plan and implemented a daily employee symptom monitoring tracking system. The tracking system allows Oneida Health to actively monitor all employees to determine their daily health status both when they arrive and when they leave. Screening includes checking an employee’s temperature twice daily and screening them for additional symptoms related to COVID-19.

Any employee who has minor symptoms or an elevated temperaJune 2020 •

The Center for Wound Healing at Oswego Health is the recipient of the 2019 Healogics Robert A. Warriner, III Clinical Excellence Award. This is a prestigious honor by Healogics, the nation’s largest provider of advanced wound care services.

The Center for Wound Healing team earned this honor by scoring in the top 10% of eligible centers on the clinical excellence measure, comprehensive healing rate weighted by wound mix. The award demonstrates the center’s continued and consistent commitment to being patient first and maintaining the highest standard of care year after year.

“We are beyond proud to be considered a center of clinical excellence.

We take great pride in the care and connection we have with patients,” said the Center for Wound Healing Medical Director, physician Carlos Dator Jr. In 2018, the Center for Wound Healing at Oswego Health was also recognized as a center of distinction.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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