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PRICELESS

This Thanksgiving ... Say ‘No Thank You’ CNYHEALTH.COM

November 2020 • ISSUE 251

LONGEVITY GAP

Physician Satish Krishnamurthy talks about recent expansion in the Upstate University Hospital’s neurosurgery department. ‘We’re confident that we can offer world-class care right here in our community,’ he says. P. 4

Read Gwenn Voelckers’ column on page 8

Wealthy outlive poor by nearly 10 years. We talk to local experts Page 19

“This is the healthiest I’ve been. So why did I just have a stroke?” P. 7

Why is Frozen Spinach Such a Healthy Choice? P. 15

Is Election Stress Getting to You? You’re Not Alone

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Is Election Stress Getting to You? You’re Not Alone

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or most Americans, the 2020 presidential election is a big source of stress, a new nationwide survey shows. Nearly seven in 10 adults (68%) surveyed called the election a significant source of stress, compared with 52% in 2016, the survey commissioned by the American Psychological Association (APA) showed. Former Vice President Joe Biden, a Democrat, is trying to unseat Republican President Donald Trump in a divisive campaign that has put a spotlight on the president’s handling of the coronavirus pandemic, the economy and widespread racial unrest. And pre-election stress is high among people of all political stripes: 76% of Democrats, 67% of Republicans and 64% of Independents, the survey found. Arthur Evans Jr., APA’s chief executive officer, said this is an election year like no other. “Not only are we in the midst of a global pandemic that has killed more than 200,000 Americans, but we are also facing increasing divi-

sion and hostility in the presidential election,” Evans said in an APA news release. “Add to that racial turmoil in our cities, the unsteady economy and climate change that has fueled widespread wildfires and other natural disasters. The result is an accumulation of stressors that are taking a physical and emotional toll on Americans,” Evans said. But some groups are feeling the stress more acutely than they did in 2016, the survey found. For example, 71% of Black adults said this election is a source of stress, compared with 46% four years ago. Adults with chronic health conditions are also more likely than those without one to say this election is stressful (71% versus 64%). Rates were lower in both groups during the 2016 campaign (55% versus 45%). And the stress, which has intensified in the past year, goes beyond the election itself. In 2020, 77% of respondents said they are stressed out about the future of the United States, up from 66% in 2019. The survey of more than 3,400 adults was conducted online by The Harris Poll from Aug. 4 to 26, 2020. If election-related stress is getting to you, you can take steps to relieve it, the APA advised. Avoid dwelling on things you can’t control and focus on what you can control. Limit your media exposure. Do activities you enjoy and get involved in things that matter to you, the experts suggested. Stay socially connected. Go for a walk or spend time with friends and family. Stay or get active physical activity helps release stress-related energy.

Thank You To our physicians, providers and employees Thank you for your resilience, dedication and teamwork as we have worked together to keep patients, visitors, staff and our community safe and healthy during this challenging time. You are true superheroes.

To our community We extend sincere appreciation to the individuals, businesses and organizations across Central New York that have generously donated financial contributions, personal protective equipment/ supplies, food, electronic devices and other items in support of Crouse Health and our fight against COVID-19.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper November 2020

crouse.org/covidthanks


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Meet

Your Doctor

By Chris Motola

Satish Krishnamurthy, M.D. Interim chairman talks about recent expansion in Upstate University Hospital’s neurosurgery department. ‘We’re confident that we can offer worldclass care right here in our community’ Q: Tell us about the changes at the neurosurgery department at Upstate. A: I am the chair of neurosurgery. We’ve always had the neurosurgeons take care of all the difficult problems that affect the brain, spinal chord and nerves. Things like injuries, tumors, strokes, aneurysms. Recently we’ve expanded the number of neurosurgeons in our department from seven to 10. We’re not all doing the same thing. There’s subspecialization. Some of us do brain tumors as a specialty. A couple of us do pediatrics. Some of us do vascular neurosurgery. A few of us do functional neurosurgergy. Most of the time seizures are taken care of by medication, but if that’s not working they often need surgical solutions to take out the area that is causing the seizures or pain, or putting in a device that records the abnormal signal coming out of the brain that causes the seizure and stops it in its tracks by giving it an electrical jolt. So it’s called responsive neurostimulation. We’re doing all the things any world-class institute would do. With this expansion of neurosurgery services, we’re confident that we can offer world-class care right here in our community, so that there’s a decreased burden on our patients and their families. They won’t have to travel to get the best treatment. Q: I take it this also includes equipment? A: We have all the technology; we have the ability to take out brain tumors completely. We can do inter-operative MRIs. And we have a robot that can precisely put electrodes into

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IN GOOD HEALTH – CNY’s Healthcare Newspaper November 2020

the brain without causing damage. Upstate is also the regional trauma center, the regional cancer center, the region’s children’s hospital, all of this means that we have a wide number of specialties available to take care of complicated problems. With brain tumors, for example, you’d want not just a neurosurgeon but an oncologist, a radiation oncologist. So you need multiple specialties. Upstate is able to cater to all of those complicated problems. We can treat metastatic tumors that get into the brain in one day with the Gamma Knife. So expansion of the program means that we can provide the best care for our community without having patients leave the area, to go to Boston, New York City or Texas to get their care. Not only is it inconvenient, but not every family can manage the expense, take that much time off of work, get insurance to approve it. We can take care all of that in your backyard. Q: Prior to the expansion, where would patients have had to go to get comparable neurosurgical care? A: We were able to cater to the majority of patients, but with the expansion of the program we can capture a larger service area. Having more neurosurgeons increases the number of things you’re able to do. We’ve been taking care of complicated cases for a decade, but now we can have people focus on specific subspecialties. You might have seen in the press that neurosurgeons are doing brain surgery while the patient is

awake, even playing guitar. We had people who could do those surgeries, but now we have people available to do those surgeries regularly and expand our services so we can cater to a lager population. Q: What’s your subspecialty? A: So I do both vascular neurosurgery and pediatric neurosurgery, but I am also specially trained in minimally invasive surgery. There are a couple of us who do minimally invasive work in the brain. Basically, minimally invasive means that you want to make the smallest cut and cause the least amount of damage to the structures you’re going through. So, for example in relation to aneurysm, you can open the head and operate on an aneurysm, or you can get there through an endovascular route, where you put a catheter through the artery in the wrist and deploy devices to close off the aneurysm. Dr. [Grahame] Gould uses the endovascular approach. I do open vascular surgery. So from a patient’s perspective it offers a choice of treatment strategies. Not everyone can be treated with minimally invasive approaches, but the people we do tend to spend less time in the hospital. For example, spinal fusion surgery may traditionally require several days admission into the hospital, but with minimally invasive approaches, it may only take one day. It also decreases the amount of pain because you’re not cutting through all the muscles. Q: Which subspecialities have benefited the most? A: It allows us to focus our efforts on brain tumors, for example. We have two pediatric neurosurgeons. We also cover the neonatal intensive care unit on Crouse Hospital. We have four functional neurosurgeons, people who deal with Parkinson’s disease and epilepsy. There’s our spine team, with a specialty surgeon. He does mostly big tumors that affect the spinal chord and spine. We have vascular neurosurgery. And then we have a neurosurgeon who does emergent critical care neurosurgery, taking care of patients who need emergent surgery. We have the region’s only dedicated neurologic intensive care unit with specially trained physicians and nursing staff with round-the-clock coverage.

Lifelines

Name: Satish Krishnamurthy, M.D. Position: Professor and interim chairman of neurosurgery at Upstate University Hospital Hometown: Bangalore, India (“Effectively Syracuse at this point”) Education: Residency: Milton S. Hershey Medical Center, Pennsylvania State University, 2000, neurological surgery; fellowship: University of Mainz, Germany, 1999; internship: Milton S. Hershey Medical Center, Pennsylvania State University, 1995, general surgery; MD: Mysore Medical College, Mysore, India, 1984 Affiliations: Upstate University Hospital; Crouse Hospital Organizations: American Medical Association, Congress of Neurological Surgeons, American Association of Neurological Surgeons Family: Wife (professor in the psychiatric department); daughter (entrepreneur) Hobbies: Keeping up with research, particularly on non-surgical treatments for hydrocephalus; outdoor activities


1 in 3 U.S. Parents Won’t Get Flu Shots for Their Kids: Survey

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he coronavirus pandemic and the upcoming flu season could pose a double threat, but many U.S. parents plan to skip flu shots for their kids, a new survey finds. Though public health experts stress the need for people of all ages to get the seasonal flu vaccine during the COVID-19 pandemic, one in three U.S. parents said they don’t plan on taking their child for a flu shot this fall. Just a third think having their child get vaccinated is more important than usual this year. Common reasons cited include unfounded concerns about side effects or mistaken beliefs that a flu shot isn’t necessary or effective. Those are among the findings from the C.S. Mott Children’s Hospital National Poll on Children’s Health at Michigan Medicine. It was conducted in August and included nearly 2,000 responses from parents of children between 2 and 18 years of age. “We may see peaks of flu

and COVID-19 at the same time, which could overwhelm the health care system, strain testing capacity and potentially reduce our ability to catch and treat both respiratory illnesses effectively,” said poll co-director Sarah Clark. “Our report finds that even during the pandemic, some parents don’t see the flu vaccine as more urgent or necessary,” she added in a poll news release. “This heightens concerns about how the onset of flu season may compound challenges in managing COVID-19.” Since 2010, the flu has caused 9 million to 45 million illnesses, 140,000 to 810,000 hospitalizations, and 12,000 to 61,000 deaths a year, according to the U.S. Centers for Disease Control and Prevention. Children under age 5, and especially those younger than 2, are at high risk for serious, flu-related complications. Last flu season, 188 children died of the flu, CDC data show.

If safety is your concern, we’ve got you covered.

Nearly 20% of Americans Don’t Have Enough to Eat COVID-19 escalated numbers for minorities, people with obesity, women

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ore than 18% of U.S. adults do not know whether they will have enough to eat from day to day, and the numbers are worse for Hispanics, Blacks, people with obesity and women, a new report shows. “The percentage of adults with food insecurity — the lack of access to adequate food — more than doubled between 1999 and 2016,” said Candice Myers, Ph.D., assistant professor at Pennington Biomedical Research Center and lead author of the article published in JAMA. “The COVID-19 pandemic has undoubtedly worsened the situation. The country may face long-term economic and health consequences unless we solve this public health crisis.” The study looked at national trends in food insecurity among U.S. adults from 1999 to 2016 using data from the National Health and Nutrition Examination Survey. The study found that food insecurity rates jumped to: • 35% among Hispanic adults, from 19.5%

• 1% among Blacks, from 12.4%. • 6% among people with obesity, from 10.4%. • 2% among women, from 8.7%. Myers said the study further solidifies the link between food insecurity and unhealthy body weight. Food insecurity has a range of health consequences, all of them negative, she said.  Obesity is key among them.  “Food insecurity and obesity are not mutually exclusive,” Myers said. “Rather, these health issues are linked in such a way that a solution will require public policy that addresses both at the same time.” Pennington Biomedical Executive Director John Kirwan, Ph.D., said the intersection of food insecurity and chronic disease highlights the impact of the research center’s work. “Our research has set the stage to not only continue our current efforts to explore these issues, but also develop new and innovative projects that delve into understanding their impact on the health of the citizens of our community, state and the entire country,” Kirwan said.

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In Good Health is published 12 times a year by Local News, Inc. © 2020 by Local News, Inc. All rights reserved. Mailing Address: P.O. Box 276, Oswego, NY 13126. • Phone: 315-342-1182 • Fax: 315-342-7776. Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Contributing Writers: Deborah Sergeant, Jim Miller, Gwenn Voelckers, Deborah Banikowski, George W. Chapman, Anne Palumbo, Melissa Stefanec, Chris Motola, Eva Briggs (MD), Ernst Lamothe Jr., Aaron Curtis, Hanan Goldberg (MD), Mary Beth Roach, Stephanie Button, Matthew G. Chaffin (MD) • Advertising: Amy Gagliano, Cassandra Lawson Layout & Design: Dylon Clew-Thomas • Office Manager: Nancy Nitz No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.

November 2020 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Healthcare in a Minute By George W. Chapman

Physician Burnout Rising An international survey of 7,500 physicians, conducted by Medscape, revealed an unsurprising increase in burnout combined with a precipitous decrease in income. Five thousand of the respondents were U.S. physicians. About 25% of U.S. docs said they plan to retire earlier with 64% reporting feeling burned out. Nine percent of U.S. physicians reported 76% to 100% lost income; 14% lost 51% to 75%; 28% lost 26% to 50% and 33% lost 11% to 25% of their income compared to last year. Basically, about half of the reporting physicians lost at least a quarter of their income due to the pandemic. The larger drops in income were among ophthalmologists, allergists, plastic surgeons and ENTs. About 54% of the physicians surveyed treated a patient with COVID-19 and 6% of the physicians got infected. Food was the top source of comfort. To make matters worse for physicians, recalcitrant and rude patients are contributing to staff and provider burnout. Agitated patients are complaining about masks or outright refusing to wear them. Others are arguing with staff about restrictive visitor policies. While the reported occurrences are rare, they are deeply upsetting to already frazzled staff. Please understand and be nice!

Big Tech Health Insurance Despite increasing scrutiny over their potentially monopolistic practices, big tech giants Google, Amazon, Facebook and Apple are venturing into tech driven health insurance. It begins with their wearable monitoring devices which gives them remote and live access to considerable and significant personal health data. Google has already launched their insurance company called Verily. Amazon offers employees coverage through its spinoff called Haven.

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It plans to offer it to its 900,000-plus U.S. e-commerce sellers. Big tech enters the health insurance market with literally billions to invest. Traditional commercial health plans like the Blues, Aetna and Cigna are limited by law to no more than 20% profit on their premiums. Any “profit” above 20% must be refunded to the buyer. (They are allowed up to three years to settle.) As long as there is the Affordable Care Act, the 20% profit ceiling should also apply to the big tech newcomers. The billions needed to survive in the industry, then, will

IN GOOD HEALTH – CNY’s Healthcare Newspaper November 2020

come from other operations. Big Tech will reap unlimited profits in wearable devices, internet sales, phones and advertising. Traditional health insurers are merging with retail drug chains where profits are not limited. If the Supreme Court determines the entire Affordable Care Act is unconstitutional early next year, expect your healthcare premiums to skyrocket as the 20% restriction on profits disappears.

Employer-based Care 2021

The Business Group on Health revealed employer plans for 2021. The pandemic has clearly impacted how they will approach next year. Most commercial insurers and selffunded plans have experienced significant decreases in claims and utilization this year, so 2021 premiums increases are expected to be in the 0% to 4% range. (Neither employers nor insurers are sure of the eventual impact of pent-up demand on costs.) Fifty-seven percent of employers said they do not plan on shifting more out of pocket costs to their employees. Fifty-three percent are interested in expanding virtual healthcare where they will also cover chronic care management, mental health, prenatal care and weight management. There seems to be an increase in employer empathy for the plight of their workers. Sixty-one percent plan to provide clinics on site. Eighty-one percent

plan on directing employees to condition specific centers of excellence.

Uninsured Increasing The impact of the pandemic is evident in fatalities, increased social anxiety, a faltering economy and loss of jobs. It is estimated that as many as 8 million workers will lose their jobs temporarily, if not permanently. Consequently, they will lose their employer based or sponsored health insurance. If the ACA is struck down, subsidized commercial insurance plans on the exchanges will no longer be an option as it is currently for 20 million Americans. Physicians and hospitals, already in financial peril due to the pandemic, are understandably concerned about the further strain on their revenue sources as patients lose their better paying commercial insurance plans.

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.


‘I Just Had a Stroke. It Was a Bizarre Experience’ By Wagner Dotto

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he past six months have been the healthiest of my life. I started a regimen of walking three to four miles every day, I nearly eliminated alcohol consumption and drastically increased eating fruits and vegetables while reducing red meat. I regularly play tennis, sleep well and don’t take any medicine — and, of course, I don’t smoke. I have been controlling the food portions I eat as well. The result is that I lost nearly 30 pounds since mid April. I’m back to being slightly overweight as opposed to obese. My score on the BMI table is 27.2 points. I weight 218 lbs. and I am 6 foot 3 inches tall. My numbers have been pretty good all along — even before my brisk-walking days. Cholesterol was low and so was blood pressure. Triglycerides have been slightly elevated, but just by a tiny bit. So, leading such a healthy lifestyle, why did I just have a stroke? It happened suddenly — as I believe all strokes do. Oct. 5 was a Monday like any other. An uneventful day at the office. The usual stress, tons of emails back and forth, phone calls, production issues, meetings, the usual stuff. I got to the office early, about 7:30; when it was about 4:30, I got ready to leave. I sent a few more emails, turned the computer off and headed out to the door. I happened to stop to talk to a colleague on the way out and I noticed my speech was a bit incoherent — my colleague noticed that as well and mentioned that he couldn’t understand what I was saying. I brushed it off, said “never mind” and went to my car. I got home 30 minutes later. Something didn’t feel right. I had difficulty opening the garage door — it seems I had forgotten how to do it — and had to ask my son, Chris, who was in the driveway, to help me. My speech was slurred. I made an effort to pronounce every single word carefully but the sound that came out of my month was unintelligible. As I got more impatient, my speech got worse. I had to communicate in writing with my son, who grew very concerned about my well-being. I was in the middle of having a stroke — and I was not aware of that.

I would never have imagined this kind of situation for me. I’m glad my son took the initiative to call 911 and the ambulance showed up in minutes. I was taken to the competent hands of health professionals at Crouse Hospital who took care of me right away. I was surrounded by six or seven providers as soon as I got to the hospital. I was happy with the care I got at Crouse. The whole episode — the drive home, the sense of confusion, the slurred speech, the trip to the hospital — lasted less than two hours. I was alert all the time and my speech gradually got better. The question remains — why did I have a stroke? The doctors ordered tons of tests and concluded that everything was normal — my arteries were fine, blood pressure was normal, I had no plaque built up in the brain and everything looked good. The issue was, they found a small hole in my heart, a condition I have had since birth, the doctors said. It’s called “patent foramen ovale.” That allowed for some bad blood to escape from this hole and hit the brain with a bit of a clot. Apparently, that was what happened. The unfiltered blood took the wrong turn in the heart and brought a tiny clot to the left side of my brain. I’m still puzzled and sometimes I’m in a state of denial. How can this happen to such a healthy guy like myself? To a person who follows every tip of good health around? Eat more fruit? Check. Avoid red meat? Check. Exercise? Check. Good sleeping habits? Check. Eat enough fiber? Check. Keep low blood pressure? Check. Keep cholesterol under control? Check. There is one little detail — I’m 63 years of age. And that’s a risk factor, according to the doctors. Still, why would I have this when I’m in my peak physical condition? Why not a year ago when I was a lot more sedentary and heavier? It’s puzzling! I guess the best explanation I got from one of the doctors was, “Shit happens.” I accept that. I’m glad this so-called stroke was minor. I left the hospital three days later, on Oct. 8. The following, Oct. 9, Friday, day I was back in the office,

working. On Saturday I was doing my regular 3-mile walking and the following Tuesday night, Oct. 13 — I was playing a two-hour tennis match at Elevate in Liverpool. Not bad for a stroke survivor. The whole thing has been pretty weird; bizarre. And I have to say it, I’m still in denial. Did I really have a stroke? At this point, only two things remind me of the episode: a heart monitor attached to my chest, which I should keep for 30 days — it transmits my heartbeat to a company which keeps track of such things, and the three medicines I have to take on a daily basis — aspirin, Plavix and Lipitor. Other than that, it’s business as usual. In a few days I will remove the heart monitor. Done. Then I will lobby my doctors to gradually reduce — and eventually eliminate — all the meds I’m taking. I always pride myself on not taking any prescription drugs. I’d love to keep it that way, if it’s possible — and safe.

Key takeaways Of all the things that happened, the main takeaways are as follows: • Call 911 — Are you very healthy? Never mind. Be always ready to call 911 when you notice something abnormal about your body. It took me too long to get into an ambulance. That could have cost me a great deal of brain cells. • You’re not invincible — Even if you’re super healthy, if you’re over 60, you are within the risk group for stroke, heart issues and other bad things. Be on the alert for bad things to happen. Things won’t get any better. • “Shit happens” — Certain things just happen. And they do happen fast, regardless of family history, your health or anything. Call it wear and tear of the body. • Better be healthy — I believe the healthy lifestyle I was leading helped my overall outcome. Had I been obese and less physically in shape, my stroke could have brought more bad consequences. I’m just speculating here. • 60s are not the new 40s — Forget about what you read or hear in the media. When you’re over 60, you are over 60 — period. It means you’re old and much more vulnerable to bad things than when you were in your 40s. • Get a good insurance plan — One of the things I didn’t need to worry about: paying my hospital bills. I’m not sure what the total tab for my four-day stay at the hospital will be — $50,000? $100,000? My insurance, Excellus BlueCross BlueShield, will take care of it. Honestly, I feel bad for Excellus I really didn’t mean to cause this type of expense.  I see health insurance pretty much like auto insurance. I pay the premiums but I don’t want to use the service. From now on I guess I will stop complaining about paying my monthly premiums.

Excellus issues $21 million in premium refund credits as part of its COVID-19 pandemic response

Excellus BlueCross BlueShield is issuing $17.6 million in medical premium refund credits to about 700 large group employer and union-sponsored plans that are prospectively rated as part of its comprehensive community response to the COVID-19 pandemic. This comes one month after the health insurer issued $3.4 million in premium refund credits to employer groups who offered the plan’s dental coverage. “Keeping health care affordable is our mission as a nonprofit insurer and it starts with not collecting more than we need to pay claims and run the business,” said Christopher C. Booth, CEO of Excellus BCBS. “When Upstate New York went into lockdown and elective medical care decreased, our claims payments also declined. We are returning a portion of the premium.” The medical premium credit will appear on the bills being sent out in November. The dental premium refund was credited on the groups’ October invoice. To date, the health plan has spent or expects to spend more than $300 million this year as a result of the COVID-19 pandemic. This has taken the form of COVID-19 related claims and expanded coverage during the state of emergency, reductions in the administrative burden for health care providers, distribution of personal protective equipment for employers and providers, and contributions to food banks and food pantries throughout the health plan’s upstate service territory. “Our priority continues to be taking care of the customer and making sure members have access to the care they need,” Booth said. “Our claim volumes have returned to normal levels given the demand for elective procedures and routine care that may have been put off during the quarantine. We are also still bracing for a possible second wave in COVID-19 related costs. We hope it doesn’t come but we are prepared if it does.” 

Visit us on Facebook @ Wagner Dotto is the editor and publisher of Local News Inc., which publishes In Good Health. Reach him at editor@ cnyhealth.com

November 2020 •

In Good Health Central New York Or Online @ www.cnyhealth.com

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Always Be Ready for a Trip to the ER

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ccidents happen, and being prepared for an emergency room visit could help speed treatment and reduce anxiety if the need occurs, an expert says. The first step is determining which ER you want to use in the event of a sudden or severe illness or injury, said Susan Promes, chairwoman of emergency medicine at Penn State Health Medical Center. “You’ll want to know what’s available in your area, and what options they offer,” Promes said in a Penn State Health news release. A convenient location is important, but so are the capabilities of the emergency department and hospital. “Every emergency department offers general emergency care. But are the doctors trained in the specialty of emergency medicine? If you have children, you may also want to know if there are physicians with additional training in pediatric emergency medicine,” Promes said. For your research, go to a hospital’s website, click its emergency department link, and then click on the providers to see if they’ve had specialty training. The website should also provide information about whether the hospital is a trauma center equipped to stabilize and treat critical injuries, she noted. When you arrive at the ER, you should have a list of all current medical conditions, medications and doses, and any known allergies. “I’d even list any previous surgeries and their dates,” Promes said. “It would also be helpful to know who your doctors are and what their phone numbers are in case the emergency medicine physician needs more information to provide the best care.” Keep this health information in a purse or wallet, or store it in a cell phone, she suggested. Another recommended document to have ready, especially for older adults, is a Physician Orders for Life-Sustaining Treatment form. “If you’re critically ill, it’s really important to be able to communicate what your wishes are,” Promes said.

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This Thanksgiving... Say ‘No Thank You’ I

f you are a regular reader of my column, you know that I usually fill my Thanksgiving column with tips and creative ways to manage what can be a challenging holiday for those who live alone. But this year is unlike any in recent history. We’ve endured and continue to endure a frightening pandemic, a divisive election process, environmental disasters, an economic crisis and increasing violence in our streets. This year, I feel compelled to share a different message. In addition to counting your blessings this Thanksgiving, I encourage those of you who live alone (as well as those who don’t) to say “No thank you” to the things that get in the way of your health and happiness. • Say ‘No thank you’ to any suggestion that COVID-19 is nothing to fear. You’ve picked up this copy of In Good Health, which tells me you are interested in your health and overall well-being. Follow your instincts and the advice of medical experts, scientists, and researchers to protect yourself, your family and your friends. We all know what to do. • Say “No thank you” to anyone who mocks you for wearing a mask, keeping your distance or declining an invitation to a gathering or event that you feel poses a risk. I’m still reluctant to go out to eat unless there is an outdoor option. That’s my choice. This is my life. Others may choose differently. That’s fine. I respect their choices and expect the same in return. • Say “No thank you’ to unreliable sources and pundits in the mainstream media and online who may be spreading fake news. Even well-meaning members of your inner circle of friends and family may share misinformation, even if unintentionally. Develop a critical eye and turn to trusted media outlets that follow rigorous editorial guidelines. Look for evidence-based stories by highly trained and experienced reporters. My favorite fact-checking site is Snopes.com. • Say “No thank you” to disrespectful, insulting and deceit-ridden public discourse. Turn it off and tune it out. Turn instead to voices of reason, empathy and compassion. When we really listen to one another and seek to understand each other’s needs, we have a prayer of moving forward and entering into productive conversations and problem solving. Even when we don’t see eye to eye, we can still show respect and treat each other with loving kindness. The challenge is to stay present, curious and connected amidst so much pain and turmoil. Let’s all do our part, big or small. Every good

IN GOOD HEALTH – CNY’s Healthcare Newspaper November 2020

intention to improve our world matters. So does every VOTE. So make a plan. Our lives literally depend upon it. • Say “No thank you” to hoarding paper items, meat and other essentials. As news of a potential second COVID-19 surge spreads, so spreads a resurgence of panic buying. Those who can’t afford to buy in bulk or easily find transportation to the store are left looking at bare shelves. They go home empty-handed, often to the expectant eyes of young children or aging parents. Let this time bring out the best versions of ourselves. Let’s exercise restraint in our shopping and acknowledge those in need. Let’s demonstrate generosity, see who needs assistance, and donate our food, time, and money for the greater good. • Say “No thank you” to disappearing into TV, a bottle, or online shopping to assuage your fears and dread of what the future may hold. It can become a slippery slope, so now’s a good time to take notice. What might feel like a welcome stress-reliever today can turn into a hard-to-break habit tomorrow. I find that daily meditation eases my anxiety and worries about the future. In the peace and quiet I can open my heart and embrace our collective goodness and care for one another. I find it reassuring and inspiring. • Say “No thank you’ to languishing on the couch except on Thanksgiving. We all get a pass that day! The more you move your body, the healthier it gets, and the better you can feel, physically and emotionally. The good news? Studies show that it doesn’t take an enormous amount of physical exercise to achieve health-enhancing results. Keep moving. • Say “No thank you’ to beating yourself up for being less than productive during this highly unusual year. These are trying times. And many of us, myself included, have experienced low energy days when we walk in circles, stare out

the window, and just can’t seem to get anything done. Let’s be kind to ourselves. Give yourself a break if you aren’t re-imagining your career, re-inventing your retirement, or re-invigorating your love life. All of that takes energy. Some days, I need all the energy I can muster just to put away the laundry. • Say “No thank you” to conversations that drift into politics during your Thanksgiving holiday. Even if you are surrounded by friends and family who share your views, the tone and language of these conversations can devolve into headshaking and criticism of the “other side.” It can become a real downer. Instead, choose to uplift the conversation. Reminisce about the good ol’ days, discuss future travel plans or talk about what’s on your post-pandemic bucket list. At my Thanksgiving table, we take turns sharing items on our gratitude list, which pairs perfectly with the dessert course! A closing note: I want to thank you for taking the time to read this column and for thinking with me about how we can help ourselves and each other during this time of unrest. I’m optimistic that together we can build our capacity for compassion, return to restorative calm, and enjoy a better, brighter, and – importantly – healthier future. Gwenn Voelckers is the founder and facilitator of Alone and Content, empowerment workshops for women, and author of “Alone and Content,” a collection of inspiring essays for those who live alone. For information about her workshops, to purchase her book, or invite her to speak, visit www.aloneandcontent.com


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IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 9


My Turn

By Eva Briggs

Types of Anxiety Disorders By Eva Briggs, MD

A

nxiety is the most common mental illness in the United States. It arises from a complex set of risk factors, including genetics and life events. It turns out that anxiety encompasses an entire cluster of disorders. Physicians use a classification system called DSM-5 (Diagnostic and Statistical Manual, 5th edition) to attempt to organize their understanding of anxiety disorders. In this column I’m going to write about various types of anxiety disorders and their features. Next month I will write about some treatments for anxiety disorders. Not included in the DSM-5 are anxiety disorders caused by medical conditions producing similar symptoms. This includes heart arrhythmias, mitral valve prolapse, chronic obstructive pulmonary disease, overactive thyroid (hyperthyroidism), hyperparathyroidism, temporal lobe epilepsy, and transient ischemic attacks (“mini strokes”). Certain medicines also may cause symptoms of anxiety.

Examples are corticosteroids, methylphenidate, selective serotonin reuptake inhibitors, theophylline, methamphetamine, substance use, alcohol withdrawal, and some complementary and alternative medicines. It’s important to exclude these secondary causes of anxiety. • Separation anxiety involves developmentally inappropriate excessive fear or anxiety about separation from home or attachment figures. It’s normal for small children to become upset if a parent leaves or they are otherwise separated from a parent figure. But that’s not normal behavior for older children and adults. Symptoms include persistent reluctance or refusal to go out, fear of being alone without the attachment figure, reluctance or refusal to sleep away from home, repeated nightmares about separation. The symptoms impair social, academic and occupational function. • Selective mutism affects less than 1% of the population. Children fail to initiate speech or respond when spoken to by others. The symptoms occur in social situations where there is an expectation for

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speaking, such as school. The symptoms last for more than one month. • Specific phobias are fear or anxiety produced by the presence of a particular situation or object. The fear is sufficiently intense to cause active avoidance or intense fear and anxiety when encountered. The fear or anxiety is out of proportion to the actual danger proposed by the object. The symptom is present for more than six months and causes clinically significant distress or impairment. Some of the most common specific phobias are claustrophobia (fear of being in constricted spaces), aerophobia (fear of flying), arachnophobia (fear of spiders), driving phobia (fear of driving a car), acrophobia (fear of heights), escalaphobia (fear of escalators), and tunnel phobia (fear of tunnels). There is even nomophobia, the fear of being without a cell phone or computer, a pathologic fear of being out of touch with technology. • Generalized anxiety disorder involves excessive anxiety and worry about a number of events or activities. Diagnostic criteria include anxiety and worry that occur for more days than not over the course of six months and difficulty controlling the worry. At least three of the following must be present: restlessness, fatigue, difficulty concentrating, mind going blank, irritability, muscle tension, disturbed sleep, anxiety, worry, or physical symptoms. The symptoms impair social, occupational, or other life situations. • Social anxiety is an intense fear of social situations where the individual may be scrutinized by others. This causes the patient to avoid social situations with fear and anxiety out of proportion to the actual threat. A subtype of this form of anxiety involves fear of performance such as speaking or performing in public. • Panic disorder entails recurrent unexpected panic attacks. Panic

attacks are abrupt surge of intense fear or discomfort that peaks within minutes. To be classified as a panic attack, at least four of the following symptoms must occur: palpitations, pounding heart, accelerated heart rate, sweating, trembling or shaking, shortness of breath, sensation of being smothered, feelings of choking, chest pain, nausea or abdominal distress, feeling dizzy, faint, or unsteady, chills or heat sensations, paresthesias (numbness or tingling), experiencing derealization or depersonalization, fear of losing control or going crazy, or fear of dying. To satisfy the criteria of panic disorder, the panic attacks must occur over a period lasting more than one month. • Agoraphobia is an intense fear or anxiety triggered by exposure to a wide variety of situations such as using public transportation, being in an open or enclosed space, standing in line or being in a crowd, being outside the home alone. The individual fears that escape could be difficult, and help might not be available if he or she develops symptoms. • Adjustment disorder with anxiety is a reaction to stressful life events. Symptoms that don’t meet the full criteria for a specified anxiety disordered may be called other specified anxiety disorder or unspecified anxiety disorder. For my next column, I will write about some ways to treat anxiety.

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

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CNY Healing Arts in Syracuse is back to offering all its services with just a few exceptions. The reopening began at the beginning of May with acupuncture and 30to 60-minute massages. In early October, skincare services returned.

Medical Spas: Open for Business By Deborah Jeanne Sergeant

M

edical spas have reopened with plenty of precautions and changes. A few area medical spas weighed in on how things are going at their locations. Chelsie Bates, spa manager for CNY Healing Arts in Syracuse, said that the spa is back to offering all its services with just a few exceptions. The reopening began at the

beginning of May with acupuncture and 30- to 60-minute massages. In early October, skincare services returned. Hot stone massage, couple’s massage and specialty massage are still not available as of mid-October. Depending upon the type of treatments offered, area spas have been reopening over the summer as

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permitted — and as they are able to adjust how they do business to comply with state regulations. “All our amenities like locker rooms, hot tubs and relaxation rooms are still closed; we can’t keep people six feet apart in these areas,” Bates said. “They now have to go right to the massage or acupuncture room.” That is a departure from the typical spa experience, where clients can spend time unwinding in the steam shower, sauna and other areas before and after a treatment. When you visit a spa next, expect to make an appointment. Do not assume you can get an appointment at the same time as a friend; many spas are staggering appointments to allow fewer in the facility at a time and to permit enough time to disinfect surfaces. The staff will ask a few questions about your health and if you have traveled recently. You will likely have your temperature taken upon arrival, use hand sanitizer and answer a few more questions. Do not bring anyone else with you. If the waiting area is open, the décor will likely be different than before with social distancing markers on the floor, Plexiglas shielding the receptionist and, so it is easier to keep the area clean, fewer soft surfaces. Like many other businesses, it is likely hightouch amenities like beverage centers will be gone. Testers are also a thing of the past. Electronic payments are preferred. The staff and providers will be wearing masks and you should, too. If your service requires you to remove your mask, remove it when asked. Your provider will likely wear a face shield and gown. The service area and protocols will likely be different, too.

For example, only one or two people at a time are permitted inside CNY Healing Arts at a time to allow for social distancing. Because these measures are meant to thin the crowds, Bates said that as far as the number of patrons at CNY Healing Arts returning to normal, “we’re not completely there yet because we can’t have the therapists we had on before. We have five instead of 10 because we’re only at 50% capacity because we have only 10 rooms.” There’s also the factor of clients feeling inhibited about safety. “Business was a little slow in the beginning as they weren’t sure of the protocols,” Bates said. “We assured them when scheduling that we’re following the proper procedures for sanitizing.” Instead of the previous 15 minutes of cleaning between appointments, the spa now performs 30 minutes of deep cleaning to ensure all touched surfaces are disinfected and that the cleaning procedure is documented. Helendale Dermatology & Medical Spa in Rochester reopened for dermatology May 18 with similar precautions as and other spas. The medical spa reopened Sept. 14. Though Helendale is fully open, “capacity isn’t quite up to 100%,” said Trish Hohman, practice administrator. Apparently, it will take more time for people to feel that the precautions in place will reduce the risk to a comfortable level. “It’s still just as important to take care of yourself as before COVID,” Bates said. “Our therapists are giving the same quality of work they’ve always given.”

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 11

10/20/20 3:02 PM


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mong the most impactful memories I have of my mother is from around Halloween when I was maybe 6 years old. She was driving the two of us home from a trip to the store when we came upon a car crash. This was in the late ‘80s — before the age of cell phones — so, we arrived at the crash scene before first responders. I remember the commotion outside the car window as my mother pulled over to the side of the road. The worried faces around the damaged vehicles scared me, so I asked her not to get out of the car. Considering the potential injuries at the scene of the wreck, my mother told me she had to. “I’m a nurse,” she said. I don’t remember the details of the crash beyond that, but what stands out about that moment was my mother’s commitment to helping even those she didn’t know. In January 2019, my mother, Linda Curtis – a nurse both in practice and in spirit – died after a battle with a rare disease called amyloidosis. Amyloidosis is a group of different diseases that is caused when an abnormal protein, called amyloid, is produced by the body and attaches to tissue and organs, interfering with their normal function. My mother was 75 when she comfortably died inside her home in Ontario, Wayne County, where she raised her three children. She was surrounded by family — including her closest friend, Steckel Steckel — when she took her final breath. Steckel knew my mother more than anyone. The two met in college and attended the same nursing school in the late ‘60s. They ended up reunited in a war-ravaged Vietnam in the early ‘70s, where they traveled for missionary worfk as nurses. They helped design and manage a health clinic in the city of Da Lat, where they assisted the South Vietnamese as well as the indigenous population with their medical needs. Steckel recalls late night feeding-sessions with malnourished babies brought into the clinic. “She loved it,” Steckel said about my mother. “She thrived on it.” The threats of war were all around them. Steckel said fellow missionaries were captured by Viet Cong, others murdered. My mother’s brush with death occurred when she contracted black water fever, a complication from malaria. With death a real possibility from the illness, she was airlifted to a hospital in Saigon. “When the nurse and the physician came in to check on her, the physician said, ‘Black water fever. That’s a one-way street,’” Steckel said. Steckel recalls later asking my mother what she thought when she heard the doctor’s grim prognosis. “She said, ‘I was too sick to care,’” Steckel said. “But she made it. She survived.” My mother showed the same resilience in her battle with AL amyloidosis, or amyloid light-chain amyloidosis — the most common form of amyloidosis in the U.S. Physician Frank Passero, a hematologist at the University of Rochester Medical Center, explains light chains are pieces of antibodies made by plasma cells in bone marrow. For those suffering from AL amyloidosis, the plasma cells make too many light chains which misfold and bind

Page 12

A photo of Carol Steckel, left, and Linda Curtis, taken in 1972 when Curtis first arrived in South Vietnam. Steckel and Curtis carried out missionary work as nurses in the war-torn country. In January 2019, at the age of 75, Curtis died after a battle with AL amyloidosis.

New Program Offers Amyloidosis Patients Hope Amyloidosis is a rare disease that affects 12 people per million. Rochester now has a program dedicated to the treating the disease and finding a cure for it By Aaron Curtis together to form amyloid fibrils. The fibrils then attach to organs, suppressing their function. Signs of the disease were first detected in my mother’s kidneys in March 2016, and later in her heart, thickening its chamber walls and restricting blood flow. In late 2017, the disease started to impact her gastrointestinal tract, which Steckel described as “the final blow.” My mother received chemotherapy to treat the disease until July 2017, at which point they focused on providing comfort care. Steckel recalls one of my mother’s doctors later saying he didn’t think she would

IN GOOD HEALTH – CNY’s Healthcare Newspaper November 2020

survive beyond six months when he saw my mother’s condition. “She proved them all wrong,” Steckel said. “I think she lived by her determination,” she added. “She just wanted to be around as much as she could for her children and grandchildren.”

Comprehensive amyloidosis program Steckel points out that she and my mother were not familiar with amyloidosis when she received the diagnosis.

Amyloidosis is classified as a rare disease by various health organizations. Mary O’Donnell, president of the Amyloidosis Foundation, shares a statistic that suggests there are approximately 12 cases per million persons, per year diagnosed with AL amyloidosis. “Most people when told they have amyloidosis never heard of the word before,” said O’Donnell, who started the foundation after her now deceased husband was diagnosed with the disease in 2002. “It’s just not something that an everyday general practitioner will begin to think of.” According to hematologist Passero, because of its rarity, patients with amyloidosis have an unmet need. This provided the motivation for Passero, along with physician Himabindu Vidula, to start the University of Rochester Medical Center’s Comprehensive Amyloidosis Program. “It’s not uncommon that patients are diagnosed years after it has first emerged,” said Vidula, a cardiologist at the hospital. “It’s also not that uncommon for patients to see multiple specialists before someone comes up with the diagnosis. That’s why we started this program. We wanted to be able to better diagnose patients and be able to treat different aspects of patients in a more collaborative manner.” Passero stressed the importance of early detection, as the longer a person has amyloidosis without treatment, the greater its impact on the body. There are different types of amyloidosis, which, aside from AL amyloidosis, includes hereditary amyloidosis, caused by inheriting a gene mutation, and wild-type amyloidosis, which tends to affect those over 70. However, in many cases, Passero points out it is unclear what causes amyloidosis. Considering my mother’s roughly three years in Vietnam during the war, I was interested to learn about the Institute of Medicine’s 2007 report, titled “Veterans and Agent Orange: Update 1996.” The report states there is limited suggestive evidence of an association between exposures to the compounds found in the herbicide Agent Orange and AL amyloidosis. Agent Orange is an herbicide used by the U.S. military as part of its chemical warfare program during the Vietnam War. According to Department of Veterans Affairs website, because of this potential link, Vietnam veterans who develop AL amyloidosis and were exposed to Agent Orange or other herbicides do not have to prove a connection between their disease and service to be eligible to receive VA health care and disability compensation. It’s an interesting link to consider when thinking about my mother’s illness, but one I think she would agree didn’t matter in her case. A war-torn Vietnam was where she wanted to be regardless of the dangers. It was a place where she could help those who needed her the most. “There were long days and sometimes long nights,” Steckel said. “But she loved where she was. She loved what she was doing. It’s where her heart was.” For more about UR Comprehensive Amyloidosis Program, visit urmc.rocheter.edu. For more about the Amyloidosis Foundation, visit amyloidosis.org.


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IGH_cancerJuly_4.75x13.75.qxp_Layout 1 6/24/20 7:27 PM Page 1

Things You Should Know About Bones, Joints

By Ernst Lamothe Jr.

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n the foundation of the human body, bones and joints remain a critical structure for our bodies. Many times people overlook the value of making sure their skeletal system is strong. Maintaining healthy bones requires more than just a doctor’s visit once in a while. Orthopedic experts believe it is important that people should treat their bodies and bones as the prized possessions they are. “Healthy bones are the scaffolding of your body and your muscles are the workers that allow you to do all the physical activity you want. It cannot be underestimated how essential it is to have strong bones. You can’t take for granted how it can affect your quality of life,” said orthopedic surgeon Michael Orio, who is affiliated with Syracuse Orthopedic Surgery. Orio gives five tips to maintaining healthy bones and joints.

1.

Intake Calcium

Why calcium? Because it’s a major mineral in your bones. Research shows a calcium-rich diet, including foods and supplements, helps build and protect your bones. Calcium is a mineral that the body needs for numerous functions, including building and maintaining bones and teeth, blood clotting, the transmission of nerve impulses and the regulation of the heart’s rhythm. About 99% of the body’s calcium is stored in the bones and teeth. The remaining 1% is found in the blood, muscle and other tissues. Calcium enables our muscles to contract and our heart to beat. “Calcium is one of the building blocks to bone structure. It is integral that we have the proper vitamins and minerals in our bodies,” said Orio, who specializes in reconstruction surgery such as hip and knee replacements. “All the things you want to do in life whether it is something simple like taking a walk or doing strenuous activity, you can’t do anything comfortably if you have constant joint pain.”

2.Vitamin D

Vitamin D plays an important role in protecting your bones, both by helping your body absorb calcium and by supporting muscles needed to avoid falls. Vitamin D is unique because your skin actually produces it by using sunlight. Fairskinned individuals and those who are younger convert sunshine into vitamin D far better than those who are darker-skinned and over age 50. Vitamin D can help build strong bones, and adults need it to keep their bones strong and healthy. “Calcium and vitamin D are the Batman and Robin for your bones. Even though we get most of our vitamin D through sunlight, the reason why it is important is because it allows our bodies to absorb calcium into our digestive tracts. If you are vitamin D deficient then you are likely calcium deficient and it will

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Orthopedic surgeon Michael Orio, who is affiliated with Syracuse Orthopedic Surgery. be difficult to maintain strong and healthy bones.”

3.Exercising

Wolff’s Law states that your bones will adapt based on the stress or demands placed on them. When you work your muscles, they put stress on your bones. In response, your bone tissue remodels and becomes stronger. Significant data exists stating that regular motion reduces stiffness and increases flexibility. Whether you choose low impact exercising such as hiking or walking or more strenuous workouts like running, swimming, dancing or tennis, moving the body on a regular basis can help prevent rigid bones “That is why we encourage people to be active because it will make your bones stronger,” said Orio.

4.

Eat Fruits and Vegetables

Eating proper nutrition and having a well-balanced diet continues to be the key. Experts recommend whole grains, fruits, vegetables and lean meats and to avoid large amounts of processed sugar. “The foods we put in our bodies have a multitude of consequences to our bones and joints. Your body can’t function in its full capacity when you are putting in foods that are high in all the substances that are not good for you,” said Orio.

5.

Avoid smoking

In addition, avoiding smoking at all costs is reommended. Smoking rates in the U.S. have declined in recent decades. However, about 15.5% of the population — or about 37.8 million adults — smoke cigarettes, according to the latest numbers from Centers for Disease Control. Smoking is an issue that leads to disease and disability and harms nearly every organ of the body and is the leading cause of preventable death. “We all know that smoking causes a lot of issues in the body,” added Orio. “Nicotine and chemicals associated with smoking impede the rebuilding process and lead to weaker bones. It is imperative that people stop smoking for various health reasons.”

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Parenting By Melissa Stefanec

MelissaStefanec@yahoo.com

If You Have (or Know) a Child, You Should Read this Article

I

thought about headlining this article with its topic. However, I realized I would lose some of my audience by the end of the headline. That’s because this article is about common misconceptions surrounding child sexual abuse. It’s a topic most people don’t want to think, speak or read about. It’s uncomfortable, disgusting, off-putting and depressing. It’s also underreported and grotesquely common (as many as one in nine children will experience it). As a society, we owe it to victims — past, present and future — to start learning and talking about it. I hope I haven’t lost you yet, because a child you love may be a current victim. An adult you love may be a survivor. A family member, a coach or a preacher you respect may be a perpetrator. Perhaps equally as disgusting is that for every perpetrator there are people who cover up that abuser’s actions. People turning a blind eye to abusers perpetuate abuse. The cycle breaks when we are willing to educate ourselves and take action. In the past year, for professional and personal education reasons, I’ve learned a lot about sexual abuse of minors. I’ve discovered people have a lot of misconceptions. That needs to change. Awareness is the first step in dismantling any societal ill. Awareness saves lives. That’s not a platitude; it’s a refrain we should repeat every time we confront something terrible and uncomfortable.

These misconceptions are just the tip of the proverbial iceberg. I’ve listed my sources at the end of this article. I hope you can find the strength to read on and keep learning, because until child sexual abuse stops, we haven’t done enough. [Trigger warning: some of the text below is graphic and may not be suitable for young readers or survivors.] • Misconception No. 1: Child abuse looks like ______ Fact: A lot of people aren’t even sure what constitutes child sexual abuse. That’s because it’s a harrowing list of activities most of us have trouble processing. Any of the following acts between a minor and perpetrator are considered sexual abuse: exhibitionism or exposing oneself to a minor; fondling a minor, intercourse with a minor, masturbating in the presence of a minor or forcing the minor to masturbate; obscene phone calls, text messages, or digital interaction; producing, owning, or sharing pornographic images or movies of children; sex of any kind with a minor, including vaginal, oral or anal; sex trafficking; or any other sexual conduct that is harmful to a child’s mental, emotional, or physical welfare. • Misconception No. 2: Strangers are the biggest threat to children Fact: The majority of children who are sexually abused are abused by a family member or an adult they are acquainted with. As many as

93% of victims under the age of 18 know their abuser. For every time we talk to our children about “stranger danger” we should talk to them about “sexual danger from people we know.” • Misconception No. 3: If I don’t have clear evidence or abuse, I shouldn’t report my suspicion Fact: Reports of suspected child abuse or maltreatment should be made immediately to the New York Statewide Central Register of Child Abuse and Maltreatment, commonly known as the Child Abuse Hotline, at 1-800-342-3720. This hotline operates 24 hours a day, seven days a week, 365 days a year. You can report anonymously. Any information is helpful. If you believe a child is in immediate danger, call 911. • Misconception No. 4: Child sex abuse only occurs between adults and children Fact: Children can sexually abuse other children. Siblings and playmates can be perpetrators. Sometimes, child perpetrators are victims of sexual abuse themselves. • Misconception No. 5: Boys (and men) aren’t sexually abused Fact: Men and boys can be victims sexual abuse, regardless of their societal status, religion or sexuality. As many as one in six men will be sexually abused in their lifetimes. There is often an increased stigma for male victims, a stigma that keeps many of them from reporting their abuse. • Misconception No. 6: Women don’t sexually abuse children Fact: Women are perpetrators of sexual abuse. They may be the abuser or facilitate abuse. The statistics vary, but reports list females as the perpetrator in 5% to 20% of child sex abuse cases. • Misconception No. 7: There will always be physical signs of child sex abuse Fact: There are physical signs of child sexual abuse, but there are also many behavioral changes. These

The Quest to Raise Prostate Cancer Awareness 190,000 men will be diagnosed with the disease this year in the U.S. By Hanan Goldberg, MD

P

rostate cancer is the most common cancer in men and is the second most common cause of cancer death in the U.S. More than 190,000 men will be diagnosed with prostate cancer this year in the U.S., with almost one in nine men being afflicted by this disease in their lifetime. More than 30,000 men will die from prostate cancer this year, with a prostate cancer-specific death occurring every 16 minutes. Most commonly, prostate cancer manifests as a localized silent disease, which progresses slowly with minimal or no symptoms. Once cancer has spread out of the prostate to local organs or bones, symptoms become more prevalent. Due to the nature of this disease, only active screening can lead to early diagnosis. Long-term studies have demonstrat-

Page 14

ed an approximate 30% decrease in prostate cancer mortality with screening and early detection. Screening of prostate cancer is relatively simple, performed with a digital rectal exam (DRE) and a blood test for prostate-specific antigen or PSA. According to the National Comprehensive Cancer Network (NCCN) guidelines, men over 45 should discuss prostate screening with their physicians. For men at increased risk (known family history, known genetic risk factors, or African descent), discussion about screening should start even earlier, at the age of 40. Localized prostate cancer treated at an early stage has been shown to have a five-year cancer-free survival rate of almost 100%. Nowadays, there are various treatment strategies available, ranging from active sur-

IN GOOD HEALTH – CNY’s Healthcare Newspaper November 2020

veillance (frequent monitoring of the disease with no active treatment) to surgery or radiation. Unfortunately, men are known for not actively seeking preventive care. Due to the recent COVID-19 pandemic, men have been even more reluctant to go to clinics and hospitals and undergo screening for prostate cancer. This is unfortunate as prostate cancer — as many other diseases — continues to rise in prevalence and affect more men. Severtal attempts have been made through various methods to raise awareness of this prevalent cancer and promote screening and early diagnosis. The implementation of prostate cancer screening has been one of the main reasons for the decrease in cancer-specific death by more than 50% from 1993 to 2017.

changes include: changing hygiene standards; developing phobias; exhibiting signs of depression or PTSD; having trouble in school; experiencing nightmares or bed-wetting; possessing inappropriate sexual knowledge; being overly protective and concerned for siblings; exhibiting regressive behaviors; running away; inflicting self-harm; and avoiding physical contact. • Misconception No. 8: Abusers are mean to the minors they abuse Fact: If you don’t know what grooming is, please educate yourself via the links below. Many sexual abusers go to great lengths to earn their victims’ and adults’ trust, whether that victim is 4 or 14. They do nice things for their victims. They may seem to love their victims. Not all child sexual abuse includes violence or physical coercion. If these misconceptions drive you to take action for yourself or someone in your life, here are some places to start. If you are a victim of sexual abuse, you can talk to someone anonymously. Call the National Child Abuse Hotline at 800-4-A-CHILD (422-4453), any time 24/7. To speak with someone who is trained to help, call the National Sexual Assault Hotline at 800.656.HOPE (4673) or chat online at online.rainn.org. Here are some helpful links to more information about child abuse: • www.rainn.org/articles/ child-sexual-abuse • https://1in6.org/ • www.bmj.com/content/ bmj/300/6733/1153.full.pdf • https://theconversation.com/ women-also-sexually-abuse-childrenbut-their-reasons-often-differ-frommens-72572 • https://pubmed.ncbi.nlm.nih. gov/25635900/ • https://ocfs.ny.gov/main/prevent_child_abuse.asp • www.rainn.org/news/grooming-know-warning-signs

As a man, father and son to a prostate cancer survivor, and as an active uro-oncologist treating prostate cancer patients, I implore all men older than 45 to go and get screened for prostate cancer as soon as they can. Help us raise awareness and spread the word. Please join our important quest to fight this disease by reaching out to more men and improving early diagnosis rates.

Physician Hanan Goldberg is an urooncologist with Upstate Urologists in Syracuse. He is also assistant professor in the department of urology at Upstate Medical University. He is actively engaged in treating prostate cancer patients and his research focuses on prostate cancer prevention, diagnosis and treatment.


SmartBites

The skinny on healthy eating

What’s Makes Frozen Spinach Such a Healthy Choice

promote better vision and may help hold off age-related eye diseases, like cataracts and macular degeneration. These same antioxidants, along with several others in spinach, including vitamin C, also boost immune function. Spinach is a vitamin A superstar, providing over twice your daily needs in an average (frozen) serving. This workhorse nutrient is essential for preserving your eyesight, may lower your risk of certain cancers, and supports both bone health and a healthy immune system. More good reasons to fill your freezer with spinach? This nutritious green is a terrific source of folate (vital for a healthy pregnancy), iron (helps prevent anemia), and fiber (keeps things humming south of the border).

Healthy Spinach Gratin Serves 4 to 6

F

resh, frozen or canned spinach is a superfood. Nutrient-dense and calorie-light, this dark, leafy green provides a remarkable array of health benefits, above and beyond Popeye’s claim to fame. This month’s column features frozen spinach for three key reasons: it lasts up to a year in the freezer; it’s just as nutritious as fresh spinach (in some cases, more); and it’s a versatile vegetable to have at your fingertips. Spinach is super good for bones, thanks to its rich supply of two very

important nutrients for bone health: vitamin K and magnesium. Just one-half cup of frozen spinach has an astounding 600% of your daily vitamin K needs. Vitamin K may help to lower your risk of bone fractures, and both vitamin K and magnesium improve bone density. Eyes light up for spinach because it contains two potent antioxidants — lutein and zeaxanthin — that can help protect peepers from harmful ultraviolent rays. Studies suggest that diets rich in these two nutrients

1 16 oz. bag frozen spinach, thawed 2 teaspoons olive oil ½ onion, chopped 2 cloves garlic, minced 1/3 cup low-fat milk ½ cup Greek or plain yogurt 1 tablespoon reduced-fat mayonnaise 1 tablespoon lemon juice ¼ teaspoon nutmeg pinch of cayenne pepper (optional) salt and pepper, to taste 2 tablespoons whole-wheat breadcrumbs 2 tablespoons grated Parmesan cheese Preheat oven to 450 degrees. Lightly coat a 2-quart baking dish with oil or nonstick cooking spray.

Helpful tips

For maximum vitamin retention—whether using fresh or frozen—use quick-cooking methods that don’t include water (or very little): steaming, microwaving, stir-frying or sautéing. When using frozen spinach for soups and stews, you can reduce vitamin C loss by adding it, unthawed, directly to your dish. Other dishes, such as casseroles, however, do turn out better if spinach is quickly thawed in the microwave. Lastly, check with your doctor before consuming spinach in any form, as its nutritional profile is not for everyone. Squeeze water from thawed spinach and put in medium bowl. Heat oil in skillet over medium-high heat. Add chopped onions and sauté until softened, about 5 minutes. Add garlic and sauté 1 minute more. Transfer mixture to bowl with spinach and combine. In small bowl, whisk milk, yogurt, mayonnaise, lemon juice and spices until blended. Combine with spinach mixture; transfer to prepared baking dish; top with breadcrumbs and Parmesan cheese. Bake for 10 to 15 minutes.

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.

Food + Diet

Couples Who Lose Together Lose More By Deborah Jeanne Sergeant

A

study published in August by Lotte Verweij, a registered nurse and Ph.D. student at Amsterdam University of Applied Sciences, the Netherlands, indicates that couples lose more pounds than people going alone. Although the study of 824 patients focuses on heart attack survivors who would benefit from weight loss, smoking cessation and physical activity, the study’s most striking finding is that undertaking weight loss with a partner rather than solo works better. “Lifestyle improvement after a heart attack is a crucial part of preventing repeat events,” said Verweij as quoted by www.sciencedaily.com. “Our study shows that when spouses join the effort to change habits, patients have a better chance of becoming healthier--particularly when it comes to losing weight.” Those with a partner were more than twice as likely to participate in a healthful lifestyle change than those without a partner. The finding makes sense to physician Az Tahir, who practices holistic health at Syracuse Holistic Internal & Family Medicine. “Anything done by family to-

gether brings results and love,” Tahir said. He said that in addition to fitness activities, eating healthful meals and engaging in stress reduction together are important as well. “I also suggest family pray, meditate, [practice] yoga and play together,” he added. So, what is so helpful about getting healthy together? “This has been proven over and over again and I’ve seen it in action firsthand over my 30 years as a personal trainer,” said Randy Sabourin, team leader at MetroFitness in Syracuse. “It goes one of two ways, either the significant other supports, encourages and even participates or they work to sabotage the effort because they are unwilling to make changes to their own habits.” When he starts with a new client, he always invites the spouse or significant other to the consultation to explain that “making healthy behavior changes is going to take a strong support system from the people you spend the most time with. You can only tough it out so long when you are drinking water and snacking on air-popped popcorn while your spouse is drinking beer and eating

chips next to you. Or you are setting your alarm to get up early to go for a walk and your spouse sleeps in.” The hassle of cooking two meals — a healthful one and a not-sohealthful one — can become a drag. But cooking a healthful meal to share with someone who wants unhealthful food can hurt the relationship. In addition to food, the principle applies to fitness. Undertaking something painful (beginning to exercise again) is easier when someone else is with you. If the other person is not ready to get healthy with you, you can do it on your own with a little planning. “If your spouse is unwilling to spend ‘healthy’ time with you, I’d encourage you to find a ‘healthy’ friend to spend more time with,” Sabourin November 2020 •

said. Joining a group or class of like-minded people you do not know can help. That helps build in accountability and support. It may need to be a virtual group; however, the effect is similar. Phone apps may also assist in weight loss, since they can be used to track movement, lead workouts, record calories and in a sense become more accountable. “Eventually, the spouse should recognize that you are serious about getting healthy and taking better care of yourself,” Sabourin said. “Do this but never stop encouraging and asking your spouse to participate and suggest fun ways to be active together.”

IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 15


complexity of those calls and those concerns, those crises. Or, again, the stress related to the uncertainly seemed to increase. But we’re this far into this, I think we’re just holding our breath, waiting, to actually see that increase in the number of more crisis-related calls. Q: Is that because you think it’s just been so long, and people are afraid? A: I think it’s been so long, and we still have no national plan and we still don’t know where we’re going or what we’re doing. Things change from day to day. I think people are starting to feel traumatized.

Q A &

with Pat Leone

Contact Community Services director says calls to the agency’s hotline and suicide prevention has remained steady during the pandemic By Mary Beth Roach

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at Leone has been the executive director of Contact Community Services for a little more than 14 years. It’s an organization that has operated 24/7 since it was started in 1971. Its mission, as Leone puts it, “is to support the social, emotional, behavioral and mental health of children, youth and adults. Our goal is to improve the quality of their lives.” It provides 24-hour telephone counseling, suicide prevention, crisis counseling, information and referral. Leone oversees a $5 million budget, a staff of 55 full-time and about 35 part-time employees, along with, as she puts it, “the gift of about 50

volunteers.” Q: During the pandemic, have you seen an uptick in hotline calls or need for services? A: I think the uptick really has been on the 2-1-1 end. It’s really been more the information and referral. Onondaga County was giving out clear information, and we help them. Surprisingly, we haven’t seen an uptick in our hotline services – either the local Contact Hotline or the National Suicide Prevention Lifeline, which we do answer regionally in New York state. What we have seen over time was an increase in the

Q: Do you need more volunteers to staff the calls or whatever other roles your volunteers fill? A: Generally, I would say yes. At this moment in time, I would say no. It’s really just because, given the situation, it’s such an intensive training and it’s such an in-person training, for such a long period of time, we’d rather work with those folks that we have than try to bring on new volunteers now. Q: You’ve been with the agency now for a little over 14 years. What would you say has been the most rewarding aspect of your job? A: There’s so many things. I think I’d have to pick is that how amazed I am with the caliber of persons I work with — whether they’re a staff person or a volunteer. How committed they are to the work that they do and to provide the very best service for folks as they can. Q: What is the budget for the whole agency and how is it funded? A: It’s just over $5 million. We’re primarily funded through different types of contracts and grants. We have some governmental contracts — federal, state, and local — and we also have non-governmental contracts, which primarily would be with different school districts. Through the Crisis Intervention Services, we do a lot of what we would say a contract or a for-fee service that would often be after-hours for different mental health clinics and facilities, so they get that 24-hour coverage. We’re on 24 hours a day. Q: Some of those contracts that you have are with entities that are facing their own financial difficulties. So how has that impacted your operation? A: I think right now that’s the 20-million-dollar-question. How badly is the state being hit? How badly is the county being hit? What did they know that they’re able to share with

us or not share with us? What does that mean in terms of our planning? Right now, we do anticipate we absolutely will be facing some budget cuts, particularly as we hit 2021. We just don’t know exactly what they will or won’t be. We’re waiting to see. We were so happy to see that the county had a little bit of reprieve for October in terms of sales tax, which we’re hoping, without any direct information, that will also translate into a slower cut, if you will, from the county for not-for-profits. Q: You mentioned the two divisions – Crisis Intervention Services and the School Services Division. What kind of work does each one of those divisions do? A: I’d say the unifying factor is that no matter what service or program in Contact, we’re really a prevention or early intervention program. In Crisis Intervention Services, the modality they use is telephonic. We do a lot of stuff via phone or online. Things are a little bit more anonymous. Or it might be text. That end of the agency has been open 24 hours a day, seven days a week since 1971. With Crisis Intervention Services, we would have the stuff that really is a crisis. We’re there to kind of de-escalate, to get [people] to a better place more quickly. We’re there to support them, to get help to them, if need be. Next to that, and this has been the last 10 or 15 years, we’ve added more of the information and referral piece, so we function as a 2-1-1. We’re AIRS certified [Association for Information and Referral Services]. Finally, we do the community support, where we do training on suicide prevention. We support the Onondaga County Suicide Prevention Coalition. School Services are preventionand early intervention-focused. They can be working with children themselves, families, children and their families. They can be working with teachers, but that tends to focus on the social and emotional development and learning and behavioral. We work in quite a few districts. We’re in the city of Syracuse, we’re in Solvay Union Free, Liverpool, East Syracuse-Minoa and North Syracuse, primarily. Until the pandemic we were in the school on a daily basis. Now, we’re learning as quickly as we can how to support both in person and remotely. For those in crisis or need information or referrals, visit contactsyracuse.org. A screen will pop up with pertinent phones to call for assistance.

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WE’VE DOUBLED OUR HEART TEAM THE CARDIOVASCULAR GROUP OF SYRACUSE HAS JOINED UPSTATE CARDIOLOGY FACULTY.

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physicians and

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office locations. Our united expertise brings you advanced technology and streamlined care.

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provide connections to research and surgical care.

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

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 17


Golden Years

Some Seniors Still Wary of Doctor’s Visits By Deborah Jeanne Sergeant

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ocial distancing may curtail the spread of COVID-19, but it brings its own drawbacks, one of which is the hesitancy of many seniors in seeking care from their providers for ongoing conditions. Considering the higher risk seniors have of contracting COVID-19, some concern is warranted — and that is the take-away message that has made a deep impression on many older adults who have chosen to stay home as much as possible during the pandemic. “There was a lot of anxiety and fear when the pandemic hit in March,” said Joelle Margrey, clinical nurse leader and vice-president of skilled nursing at Loretto. Though initially providers wanted to delay any care that did not involve a life- or limb-threatening condition, COVID-19 is now better understood, infection rates are down and providers know how to reduce the risk of transmission. “At this point, I feel that people are comfortable and confident with what we have done to make sure of everyone’s safety and wellbeing,” Margrey said. We’ve been provided a lot of research and information. The New York State Department of

Health has given information we’ve integrated into our policies and procedures.” These include guidelines on using personal protective equipment, masks, social distancing and increased cleaning protocols to keep residents safer. Anyone interested in Loretto can virtually tour the facility; in-person visits have not returned. News stories with dramatic accounts of sickened seniors and climbing infection and death rates may make staying home the better idea until the pandemic goes away. However, Margrey encourages older adults to not further delay medical care, as delaying care for a health issue — even one not urgent — can mean worse outcomes. Fortunately, between telehealth and routine in-house physician care, Loretto residents seldom need to leave for healthcare. “Anything we’re unable to accomplish internally, we use telehealth,” Margrey said. “Telehealth has been a tremendous asset. We have it internally and when they’re discharged from short-term rehabilitation, we set them up with telehealth at home. Once they become familiar with the equipment, they

have a real sense of security and reduction of anxiety because they can have someone at the touch of a button. They don’t have to worry about transportation.” It has been so well received that Margrey plans to continue to distribute telehealth equipment for discharged patients and to use it within the facility. During the height of the quarantine, most providers began offering telemedicine to resolve as many routine cases as possible. Things such as podiatry, optometry and dental care may be safely delayed for a short time for most patients; however, it is important to take care of these healthcare needs now, before a problem develops. Seniors especially should seek vaccination for flu and pneumonia. At The Centers at St. Camillus, Michael Connor, relationship development coordinator, said that resi-

dents receive routine care in-house. “Those who have medical appointments in the community are usually accompanied and assisted by our nursing and medical transportation staff members, whom residents and patients often know, have personal relationships with and trust,” Connor said. “These staff are also required to undergo weekly testing, increasing the comfort level of both residents and their families.” Of course, clients’ needs for medical care varies; however, they should feel free to address any concerns they have for their health with a medical provider without worrying about COVID transmission because of physicians’ heightened use of personal protective equipment and sanitation protocols. “All the efforts taken have proven to be successful, with no positive cases in almost three months,” Connor stated in October.

experience, but it makes it better than not having it,” he said. “They definitely get benefit out of it.” He also hopes that the pandemic-era use of technology will improve older adults’ acceptance of technology. But using this technology can also produce unwanted effects. For example, it can leave some older adults at risk for scammers. In a nursing home, staff are trained to help residents deal with these issues. Older adults living independently may not be aware that anything they post may be used by a scammer. The phone call scams asking for money have been enhanced by information gleaned from Facebook and other social media platforms. Criminals can more easily pose as stranded grandchildren needing money if they know the family’s background. “Scam artists will use a ‘hook’ to trick individuals into offering information,” DiCaprio-Lee said. “Scammers will prey on an older adults’ feelings of love, goodwill and

fear. Many times they’re hesitant to reach out for help. If you think about phishing, they’re reaching out and trying to get you to give up information.” A scammer who calls saying, “Grandma, I need help” in the middle of the night often elicits as a response, “Billy? Is that you?” Now the scammer has a name. Scammers can also hack into a relative’s legitimate Facebook account to glean information and to contact the elder. Usually, the scammer creates an emergency that requires the senior to wire money right away and pleads with the grandparent to not tell their parents or “I’ll get in trouble.” Knowing details from Facebook can make the scam sound more legitimate. DiCaprio-Lee said that anyone receiving a dubious phone call should “not give out personal information unless you absolutely know who you’re dealing with,” DiCaprio-Lee said.

Technology and Social Media Helpful for Isolated Seniors By Deborah Jeanne Sergeant

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umerous studies and articles have lambasted misuse of social media for its ill effects on young people caught up in bullying, obsessive posting and dissatisfaction with their own lives compared with the “perfect” lives portrayed on the screen. However, in the past year, social media has proven particularly helpful for the opposite end of the age spectrum as older adults have continued to stay at home to avoid COVID-19. “Social media can be a great tool for anyone to feel connected, especially older adults,” said Lori DiCaprio-Lee, identity theft and outreach coordinator for Vera House in Syracuse. “That disconnected feeling is heightened now. Social distancing doesn’t equal social isolation.” Whether it’s virtually attending a birthday party, chatting with grandchildren or catching up with their adult children on Facebook, technology has helped many seniors avoid feeling left out. These kinds of measures to

Page 18

enhance connection are vital to good mental health, according to Timothy Holahan, osteopathic doctor and assistant professor of medicine specializing in geriatrics and palliative care with University of Rochester Medical Center. “Socialization has always been important in nursing homes and not isolating patients,” he said. “I still think that’s very important. We just have to find good ways in terms of infection control to do that.” He believes that the pandemic has underscored how important socialization is to populations that are already somewhat isolated, including seniors living in long-term care facilities, assisted living communities and independently in the community. Holahan is also medical director for The Hurlbut, Penfield Place and Woodside Manor. He said that at the homes he oversees, HIPAA-complaint means such as Zoom or streaming events, music and pastoral care have proven popular among residents. “It doesn’t replace the in-person

IN GOOD HEALTH – CNY’s Healthcare Newspaper November 2020


Golden Years

LONGEVITY GAP

Wealthy Outlive Poor by Nearly 10 Years By Deborah Jeanne Sergeant

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esearchers with University College London recently published a study that correlates wealth as the greatest factor that indicates when a person’s health will begin declining with age. Wealthy people in the study of more than 25,000 adults over age 50 in England and the U.S. lived more than nine years longer in good health than poor people. The study indicated that wealthy women were expected to live an average of 33 years without age-related disability compared with those with less money, who live only 23 to 24.6 years in good health. Well-to-do men could anticipate 31 healthy years but poor men could expect 22 to 23 years. One reason behind the gap is where a person lives. According to the New York State Department of Health, of people in New York state who died before age 65 years, 31.6% lived in what researchers considered a low-income ZIP code while 20.9% lived in a high-income ZIP code. “It’s very complex and it’s never one thing,” said physician Sharon Brangman, department chief of geriatrics and distinguished service professor at Upstate Medical University. “It’s usually a compilation of different things and finally you get one problem that pushes you downhill. Health and poverty aren’t just one thing; it’s a compilation of little things that affect everything you do every day. Over time, that has a marked impact on your life expectancy.” Brangman doesn’t see the link between health and poverty as an

issue affecting only minorities living in inner cities. “This goes across racial lines,” she said. “If you look at poor people who live in the South or Appalachia, their problems are similar. It’s not racially based per se but is a problem of being poor in this country — the price you have to pay to exist.” She added that the difficulties of being poor — trying to figure out how to make ends meet — add significant stress to life. Lower income makes people 154% more likely to have diabetes and 224% more likely to have a depressive disorder. Chronic stress effects these statistics and other measures of health. Brangman said that chronic stress raises blood pressure, blood sugar and heart rate. “This can lead to hypertension, heart disease and diabetes,” Brangman said. “These are now being looked at from a health standpoint in terms that chronic stress plays. When chronically stress, your body makes inflammatory chemicals. That is associated with cancer and autoimmune disease. If it’s chronic stress, and chronic inflammation, that can take a toll on your body. A lot of research is looking at the role that chronic inflammation has on your body and certain disease processes.” Simply packing up and moving to a better place to live is often out of reach for people in poverty, as saving up first month’s rent, last month’s rent, a security deposit and moving expenses is impossible. Brangman said how people get stuck in the rut of poverty is that a lack of education leads to fewer employment choices. “Dead-end”

jobs with little chance of advancement means that an individual has fewer options for where to live and what to eat. People working two part-time jobs to make ends meet do not typically receive health insurance benefits. Neighborhood factors such as high smoking rates can significantly reduce life expectancies. As of June 2016, HealtheCNY.org states that the adult smoking rates in Syracuse ZIP code 13208 is 25.6%. According to tobaccofreecny.org, Onondaga County’s smoking rate is 17.2%; in Oswego County, it’s 29%; in Cayuga, 21% smoke and the rate is 17.3% throughout Upstate (any county not part of New York City). Living in a poor neighborhood often means that people live with life-limiting factors such as limited access to healthful foods, places to exercise or affordable healthcare. “If you look at the typical poor neighborhood, there’s more liquor stores or convenience stores than grocery stores,” Brangman said. “Dollar stores don’t sell anything fresh; it’s all prepared and frozen foods. When they move into an area, the rates of diabetes and obesity goes up.” Again, some of this goes back to education. Fewer people know how to cook anymore and even if they can afford good food, few poor people have the leisure time to learn to cook it. Many schools have cut home economics and if children do not learn at home, they rely more heavily on processed foods, take-out and prepared foods, all of which are generally higher in fat, sodium and simple carbohydrates than food cooked from ingredients. Poor people prioritize rent, food

November 2020 •

and utilities over things like fees for a personal trainer or gym membership. While walking and playing in a park is free, it’s not always safe in poorer neighborhoods. Brangman said that she once performed a study on how a community environment affects the tendency for residents to exercise. An area that is run down with few trees, cracked sidewalks and higher rates of crime discourage exercise such as walking or playing in parks. Access to healthcare also makes a big difference for preventing preterm birth, chronic health problems, and emergency room visits. “If you don’t have good healthcare, you don’t have coverage for expenses,” Brangman said. “You have to pay more to have work-ups, tests or to buy medication.” Michelle Brown, director of Community Health and Well-Being at St. Joseph’s Health, said that the various factors that poverty brings to healthcare “make it difficult for prioritize health needs” when the negative outcomes of neglecting health are longterm, such as diabetes after years of eating a cheap but poor diet. Neglecting the immediate needs brings short-term outcomes, such as becoming homeless because the rent was not paid. Brown said that these social influencers of health “are really all the factors that contribute to health outcomes, that have nothing to do with clinical care.” Protective factors include family and social support, community safety and education. Not everyone who has a low income is uneducated. For example, an artist or childcare provider may have a good education but not make a lot of money. Their education helps them make better lifestyle choices about health. “Education is a social influencer toward greater health outcomes,” Brown said. The Centers for Disease Control and Prevention states that adults who are 25 and lack a high school diploma can expect to die nine years earlier than college graduates. According to Healthecny.org, approximately 16.62% of Central New York residents have bachelor’s degrees, lower than the statewide rate of 20.17 percent. Brown also thinks that community-based organizations can improve the public’s relationship with healthcare providers, which she believes would improve prevention and management of chronic disease—two drivers in healthy longevity. “Our community partners are helping us understand the community we’re trying to serve,” Brown said. “We’re much stronger if we’re working with the organizations that know our community best.” Visit www.healthecny.org to read more about the area’s health statistics.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Golden Years

Medicare 101

If the rules of Medicare confuse you, you are not alone By Deborah Jeanne Sergeant

Y

es, it’s confusing. An entire industry has developed around explaining the parameters of Medicare to adults anticipating their time to sign up at age 65. While no one is required by law to sign up for Medicare, it is vital to understand the basics of Medicare to avoid lifelong monthly penalties should you decide to sign up later. In general, people receiving Social Security income (SSI) for two years for a disability are automatically enrolled. Those who are aged 65 are eligible to enroll in Medicare. The age-related enrollment period is three months before and after the person’s birth month and the birth month. A person currently with group insurance supplied by an employer of 20 or more can remain on their current plans and wait until they retire and thus lose their coverage. The same applies to a spouse on their plan. They do not have to wait until the next open enrollment period, which runs Oct. 15 through Dec. 7, because loss of coverage constitutes a qualifying event. Coverage under COBRA does not qualify. If they don’t like their current insurance, they may choose to drop it in favor of Medicare. Medicare plans are designated as “Parts.” • Part A covers hospital care and some home care. If you have worked 40 quarters in your lifetime,

it’s free. • Part B covers doctor visits, diagnostic services and other outpatient care. The base premium is $144.60 per month. Individuals making $87,000 or more or couples making $174,000 or more pay higher premiums. It’s on an income-based, tiered structure, based on income figures from two years ago.  Parts A and B together are also known as “Original Medicare.” It is not mandatory to have Medicare Part B. After age 65, those using the New York State Marketplace must sign up for Medicare. For those receiving Social Security, the premiums are deducted from their monthly checks. Those not receiving Social Security pay quarterly.  Those who do not enroll in Medicare on time will pay a penalty of 10% of the premium for each 12-month period they could have been enrolled in Part B. Someone who waited two years would pay 20% more; those waiting three years would pay 30% more per month for the duration of their enrollment. A recent change to Medicare is the Part B giveback. It rolls money into the Social Security check toward the Part B premium. • Part C, also known as Medicare Advantage, includes amenities like vision, dental care, wellness rewards and fitness. About 36% of

Older Adults Cautious on Senior Living Facilities By Deborah Jeanne Sergeant

A

re nursing homes and other senior living facilities really a safe place for seniors to live? According to a Sept. 18 article by Judith Graham published by Kaiser Health, a lot of older adults are rethinking their final planning and considering other options than going to a senior living facility should they need help with activities of daily living. The article cited a survey in August by the National Investment Center for Seniors Housing & Care that 74% of senior housing executives said families have expressed concern about safety amid rising COVID-19 cases. To assuage these concerns and to keep residents safe, the industry in general is responding with increased communication about safety, according to Kimberly Townsend, president and CEO at Loretto. “What we’re finding to be highly effective according to industry sur-

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veys, the three things families and individuals want are to understand the cleaning and disinfectant protocols and safety and control measures; to see that the facility has access to rapid testing so in the event that there is an individual who tests positive for COVID-19, there’s an ability to have everyone tested with rapid results; and to access either a robust telemedicine platform or robust on-site care.” Ramping up measures to quarantine ill residents, limit the contact of all residents with potential sources of infection, using personal protection equipment more frequently, and testing staff for COVID-19 weekly have helped curtail the virus’ spread, according to Townsend. For those with the means to do so, choosing home health may help reduce the population of people living in nursing homes to a safer capacity. Some estimate that a rate of 80% capacity helps prevent the spread of COVID-19. But it is diffi-

IN GOOD HEALTH – CNY’s Healthcare Newspaper November 2020

those enrolled in Medicare are in Medicare Advantage, as of Sept. 29, 2020. “By having a C plan, they do case management services and coordinate benefits,” said Christine Stanford, senior director of operations at Loretto. “Typically, the co-pays can be less and you can pick plans more geared toward your health needs. They all typically include prescriptions. There are other plans just for people who are in skilled nursing facilities.” The Part C plans are offered through private insurers like Blue Cross Blue Shield, Humana, Aetna, Cigna and United HealthCare and include Parts A and B. Most also include Part D. • Part D is the prescription drug plan offered through private insurance companies. New York’s EPIC program works with Part D to make prescriptions more affordable. Anyone enrolled in EPIC may change their Medicare at any time, not only during enrollment periods. • Part F has no deductibles and pays all coinsurance. It covers 80% of expenses. Supplement plans, also called Medigap, fill in areas that Medicare doesn’t cover all medications. Where you spend your time also matters. If you travel a lot or snow-

bird during the winter, make sure your plan covers non-emergency care elsewhere. Emergency care is nearly always covered. That is why seeing a broker can make a big difference in how well you are covered and how much it will cost. “There are many private businesses offering services at no charge,” Stanford said. “You don’t have to see a broker. At Medicare. gov, you can compare plans, see what’s available in your area, compare costs and premiums to choose the plan that best meets your needs. “You’d only need a broker if you’re going for Part C. There are benefits to using a broker. The brokers can help find what plan works best and they’re Medicare experts and can provide you with lots of different companies’ options. It doesn’t typically cost anything and they can help you figure out what the best plan is if you need certain drugs as far as overall costs. They typically represent multiple companies so you can compare plans with one individual. Shes recommends giving a broker a list of medication so that the broker can find what plan will save the most money.

cult to tell what level of care one will need in 10 or 20 years. “There will always continue to be a robust demand for those services that really cannot be accommodated in the home,” Townsend said. “Memory care and people with very, very complex medical conditions are likewise very challenging. I think there will certainly be more motivation to do so with Loretto’s PACE program and patient monitoring. We want to offer as many options as possible to help people stay in their homes as long as they wish and as long as it’s safe to do so.” Loretto offers home-based and community-based options for care. According to AARP, 52% of people turning 65 years old will need longterm care at some point All the changes taking place have caused caregivers to reevaluate how they operate. Michael Connor, relationship development coordinator at The Centers at St. Camillus, said that strictly following and enforcing guidelines for masks, personal protective equipment, contact, and sanitation. Like other healthcare organizations, St. Camillus had emergency processes and protocols in place; however, no one alive today has experienced a pandemic at their

workplace. Although frail elders are more vulnerable to COVID than most younger people, the nursing home industry has been working to mitigate this tendency. “Throughout the pandemic, the St. Camillus administrative and nursing staff has also remained calm and level-headed, stayed informed and communicated crucial information as clearly and swiftly as possible to our residents and their families, our staff and the community,” Connor said. “Operational procedures were revised, ongoing education provided, and compliance monitored.” The pandemic has sharpened the facility’s ability to pivot as changes occur in regulations and protocols, sometimes daily. “Some of the additional measures we have taken are introducing telehealth physician services, increasing the availability of private rooms, ensuring a 60-day supply of personal protective equipment and establishing dedicated areas to support cohorting of residents if needed,” Connor said. In addition, St. Camillus tests employees weekly and receives the results in 48 hours so that the organization can swiftly curb the spread of the virus.


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Coronavirus Vs. Flu: How to Tell the Difference Dear Savvy Senior, Can you explain the differences between the coronavirus and seasonal flu? I’m 70 years old, and usually get a standard flu shot, but would like to find out what else I can do to protect myself this winter.

Worried Senior Dear Worried, Great question! Because of the dual danger of influenza (flu) and COVID-19, the Centers for Disease Control and Prevention (CDC) recently warned that this fall and winter could be the worst ever for public health. Understanding this, knowing the differences and similarities between the viruses, and knowing what you can do to protect yourself is the best way to stay healthy and safe through this difficult time.

Flu vs COVID Because many of the symptoms of flu and COVID-19 are similar, it may be hard to tell the difference between them based on symptoms alone, so testing may be needed to help confirm a diagnosis. With that said, here are some similarities and differences you should know. For starters, seasonal flu symptoms come on pretty quickly, whereas COVID-19 develops gradually over a period of a few days and then either fades out or gets worse. Common shared symptoms include fever, sore throat, muscle aches, cough, headache, fatigue and even chest pain. Pinkeye and a dry cough are associated with COVID-19, while it’s now thought that a fever is more likely with the flu, as are diarrhea and nausea. Many people are having their temperatures taken these days before entering public spaces. But fever occurs in only half of COVID-19 cases. Fever does not rule out COVID-19, but the absence of fever makes flu unlikely. You’re also unlikely to have a runny or stuffy nose with the flu, but you may with COVID-19. What sometimes happens within the nose with COVID-19 is loss of smell and, often as a consequence, loss of taste, too. To learn more about the similarities and differences between flu and COVID-19, visit the CDC website ​ at CDC.gov/flu/symptoms/flu-vscovid19.htm.

How to Protect Yourself While there is currently no vaccine available yet to prevent

‘Centers for Disease Control and Prevention recently warned that this fall and winter could be the worst ever for public health.’ COVID-19, the best way to prevent illness is to avoid being exposed to this virus. So, stay home as much as you can. If you have to go out, wear a mask and keep at least six feet away from other people. And every time you come home, wash your hands with warm water and soap for at least 20 seconds. There’s also evidence that suggests that people who are deficient in vitamin D may be at higher risk of getting COVID-19, than those with sufficient levels. So, make sure you take in around 800 to 1,000 international units (IUs) of vitamin D from food or supplements daily, and get outside as much as you can. And to help guard against the flu this year, you should consider getting a flu shot that’s specifically designed for people 65 and older. The “Fluzone High Dose Quadrivalent” or the “FLUAD Quadrivalent” are the two options that provide extra protection beyond what a standard flu shot offers. You only need one flu shot, and if you haven’t already gotten it, you should do it now because takes up to two weeks to build immunity after you receive it.

Pneumonia Vaccines If you haven’t been vaccinated for pneumonia, you should also consider getting the pneumococcal vaccines. Both flu and COVID-19 can lead to pneumonia, which hospitalizes around 250,000 Americans, and kills around 50,000 people each year. But these numbers could be much higher this year. The CDC recommends that all seniors, 65 or older, get two vaccinations — Prevnar 13 and Pneumovax 23. Both vaccines, which are administered one year apart, protect against different strains of the bacteria to provide maximum protection. Medicare Part B covers both flu and pneumonia shots. To locate a vaccination site that offers any of these shots, visit VaccineFinder.org and type in your location. 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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Mobile Medicine: New Approach to a Doctor’s Visit Team of providers goes to a PACE-CNY participant’s home and coordinates care in a single visit By Stephanie Button

T

he COVID-19 pandemic made in-person doctor’s visits especially complicated for older adults. PACE-CNY in Syracuse saw the need for its program participants to have access to safe yet convenient medical check-ups — and introduced Mobile Med. This all-in-one interdisciplinary medical team of doctors, nurses, physical and occupational therapists, as well as recreation therapists, goes to a PACE-CNY participant’s home and coordinates care in a single visit. This approach streamlines a traditionally complicated and often time-consuming visit to a doctor’s office, helps maximize care and, most importantly, keeps participants safe by keeping them in their homes. During each visit, the Mobile Med team conducts a comprehensive and holistic assessment to ensure participants are receiving all the care they need. A Mobile Med visit can include a range of health evaluations traditionally done at a doctor’s office, as well as functional and environmental home assessments to make sure the participant’s living environment meet his or her needs. Not only are these at-home medical services safe and convenient,

• Care Management for Adults •• Care Management for Careand Management forAdults Adults Children and Children

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many participants are also excited to have visitors. After months of limited social interactions, simple face-toface conversations with a real person, even if only for a couple of minutes, truly brightened up the participant’s mood and helped ease the sense of loneliness. Loretto believes Mobile Med is more than a temporary solution — it is the future of care. This interdisciplinary approach also provides truly unique opportunities for staff throughout the Loretto system to work together, including opportunities for frontline positions like CNAs to get new experiences. To expand this much-needed service, Loretto is actively looking to hire multiple positions across the organization. Visit www.lorettocny.org/ careers for more information. Loretto and PACE-CNY are constantly exploring new ways to expand services and grow our family — including residents, program participants and staff. While the COVID-19 pandemic has certainly been a challenge, we are incredibly proud of the opportunities our team has developed to keep our residents and participants safe and happy.

Stephanie Button is vice president of PACE CNY.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper November 2020

I

Social Security Can Help With Your Plan For Achieving Self Support

f you rely on Supplemental Security Income (SSI) payments or Social Security Disability (SSDI) benefits and want to start working or return to work, we can help. A Plan for Achieving Self-Support (PASS) is a rule under SSI to help people with disabilities return to work. If you receive SSI or could qualify for SSI after setting aside income or resources so you can pursue — or achieve — a work goal, you could benefit from a PASS. How does a PASS help someone return to work? • We base SSI eligibility and payment amounts on income and resources (things of value that the individual owns). • PASS lets a disabled individual set aside money and things he or she owns to pay for items or services needed to achieve a specific work goal. • The objective of the PASS is to help disabled individuals find employment that reduces or eliminates SSI or SSDI benefits.

Q&A Q: Is it true I can save about $4,900 per year if I qualify for Social Security’s Extra Help with the Medicare prescription drug program? A: Yes. If your income and resources meet the requirements, you can save nearly $5,000 in prescription costs each year. Resource limits for 2020 are $14,610 (or $29,160 if you are married and living with your spouse). Income limits are $19,140 (or $25,860 if you are married and living with your spouse). If your income or resources are just a bit higher, you might be eligible for some help with prescription drug costs. To learn more, visit www.socialsecurity.gov/ prescriptionhelp. Q: My spouse died recently and my neighbor said my children and I might be eligible for survivors benefits. Don’t I have to be retirement age to receive benefits? A: No. As a survivor, you can receive benefits at any age if you are caring for a child who is receiving Social Security benefits and who is under age 16. Your children are eligible for survivors benefits through Social Security up to age 19 if they are unmarried and attending elementary

You can read all about the PASS program at www.ssa.gov/pubs/EN05-11017.pdf. The plan must be in writing, and Social Security must approve it beforehand. To start, contact your local Social Security office for an application (Form SSA-545-BK) or you can access the form at www.ssa.gov/ forms/ssa-545.html. There are many people who can help you write a PASS, including a Ticket to Work service provider, a vocational counselor or a relative. Social Security’s Ticket to Work (ticket) program supports career development for SSDI beneficiaries and SSI recipients who want to work and progress toward financial independence. The ticket program is free and voluntary. Please call the Ticket to Work Help Line at 1-866-968-7842 or 1-866-8332967 (TTY) Monday through Friday, 8 a.m. to 8 p.m. ET to learn more about the Ticket program. Your job isn’t just a source of income — it can be a vehicle to independence or a beginning to fulfilling your dreams. Let Social Security’s PASS help you achieve your goals.

or secondary school full time. Keep in mind that you are still subject to the annual earnings limit if you are working. If you are not caring for minor children, you would need to wait until age 60 (age 50 if disabled) to collect survivors benefits. For more information about survivors benefits, read our publication Survivors Benefits at www.socialsecurity.gov/pubs. Q: Why is it so important that my baby have a Social Security number? A: Your child may need a Social Security number if you are planning to open a bank account, buy savings bonds, obtain medical coverage, or apply for government services for the child. Your child will also need a Social Security number if you are going to declare him or her on your taxes. Getting a Social Security number for your newborn is voluntary, but it is a good idea to apply when your child is born. You can apply for a Social Security number for your baby when you apply for your baby’s birth certificate. The state agency that issues birth certificates will give us your child’s information and we will mail you a Social Security card with the child’s Social Security number. Visit www.socialsecurity.gov/ssnumber for more information.


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Biden, Trump: Both Likely to Be ‘Super-Agers’

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n a paper published in the Journal on Active Aging, University of Illinois Chicago longevity researcher S. Jay Olshansky and his colleagues conclude that both 2020 presidential candidates — former Vice President Joe Biden, 77, and President Donald Trump, 74 — are likely to maintain their health beyond the end of the next presidential term. As a result, they say that chronological age and fitness should not be factors in the 2020 election. “It is our conclusion that chronological age is not a relevant factor for either candidate running for President of the United States,” the authors write. “Both candidates face a lower than average risk of experiencing significant health or cognitive functioning challenges during the next four years.”  To evaluate each candidate’s likelihood of surviving a four-year term in office, the researchers scientifically evaluated the candidates’ health status based on publicly available medical records and confirmed publicly available personal information. The medical records of each candidate were independently evaluated by three medical doctors with experience in aging and a team of research scientists with expertise in epidemiology, public health, survival analysis, and statistics.  This is the first time that the medical records and personal attributes of presidential candidates have been scientifically evaluated by physicians and scientists in the field of aging. The key findings of the study: • Biden and Trump are likely to be “super-agers,” a subgroup of people that maintain their mental and physical functioning and tend to live longer than the average person their age. • Both candidates have a higher than average probability of surviving a four-year term in office, relative to other men their age. For Biden, the probability of surviving the next four years is 95.2% (vs. 82.2%). For Trump, this is 90.3% (vs. 86.2%).

• Biden is expected to outlive Trump, even though he is three years older. In the paper, the researchers note Biden’s “nearly perfect health profile for a man his age,” compared with Trump’s “significant but modifiable” risk factors. • While Trump is noted to have an elevated familial risk of late-onset Alzheimer’s disease, neither candidate is expected to have major cognitive functioning challenges now or during the next four years. Olshansky, the corresponding author of the study, says the results are evidence that age does not matter in this historic election in which the next elected president will be the oldest in American history. “We see chronological age as a topic of discussion time and again during elections, even though scientific and medical evidence tells us that biological age is far more important,” said Olshansky, professor of epidemiology and biostatics at the UIC School of Public Health. Biological age is reflective of how rapidly a body is growing old — this occurs at different rates, Olshansky said. “Biological age is influenced by genetics and behavioral risk factors. Some people can be biologically old at age 50 while others can be biologically young at age 80.” In 1984, Ronald Regan, then age 73, when asked about his advanced age, said “I want you to know that also I will not make age an issue of this campaign. I am not going to exploit, for political purposes, my opponent’s youth and inexperience.” Similarly, when asked about his relative youth, Sound Bend, Indiana Mayor Pete Buttigieg, who ran in the 2019 democratic presidential primary, then age 37, deflected the question. “Mayor Buttigieg said it’s the age of the ideas that matter, not the candidate — and I think that was right, too,” Olshansky said. “We can acknowledge age in an election, but all ages should be valued for the diverse perspectives and experience they bring.”

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Why Diabetes Patients Should Watch Their Kidneys November is National Diabetes Month By Matthew G. Chaffin, M.D

CENTRAL NEW YORK

HEALTHCARE GUIDE

2021 Edition ONLINE AND IN PRINT ALL GLOSSY, ALL COLOR

to advertise call 315-342-1182

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Q. Please discuss the relationship between diabetes and kidney disease? Dr. Chaffin: Diabetes is a major risk factor for kidney disease. For people aged 65 and older, one in four has diabetes. Diabetes is one of the most common chronic conditions and it is very common for diabetics to develop kidney disease. Q. How does diabetes affect the kidneys? A. In diabetes, the small blood vessels in the kidneys can be injured so that the kidneys cannot clean your blood properly. When this happens, your body starts to retain water and salt, protein leaks into your urine and develops waste materials that build up in your body. Q. Are diabetics with kidney disease at greater risk for infections?

IN GOOD HEALTH – CNY’s Healthcare Newspaper November 2020

A. Diabetics are at higher risk for all infections, and developing kidney failure increases that risk. That is why it is so important to manage your diabetes and kidney disease. Q. What are the early signs of kidney disease in diabetes? A. We see patients who have an increase of albumin in their urine based on lab testing, weight gain and swelling in the ankles, and an increase in frequency to urinate at night. Q. What is the best way people can take care of themselves if they are diabetic and have kidney disease? A. Diabetics should manage blood sugar, avoid smoking, maintain a healthy body weight, manage stress and get adequate sleep and physical exercise. It is important to keep a current medications list with

Matthew G. Chaffin, M.D, sees patients at Nephrology Associates of Syracuse and specializes in internal medicine and nephrology. He is affiliated with Crouse Hospital and St Joseph’s Hospital Health Center. To contact him or for more information, call 315-478-3311 or visit www.nephrologysyracuse.com. dose and frequency, and get a flu shot. Q. What other recommendations can you share? A. People who have specific medication questions should ask their physician. Generally, diabetics with kidney disease should at least avoid taking ibuprofen. We encourage everyone in our community to take an active role in managing your health.


H ealth News Oswego Health welcomes new cardiologist Oswego Health welcomes experi enced cardiologist, David Bass, DO, FACC to its medical team. Board-certified in cardiovascular disease and internal medicine, Bass earned his medical degree from New Bass York College of Osteopathic Medicine. In addition, Bass completed his fellowship in cardiovascular medicine at the Nassau University Medical Center. Bass has extensive cardiovascular experience throughout New York state, including being a non-invasive cardiologist at Canton Potsdam Hospital. He is a fellow of the American College of Cardiology; diplomate status with the American Society of Nuclear Cardiology; and a diplomate with the National Board of Echocardiography. “Access to cardiology care is so important to our community,” said Oswego Health Chief Medical Officer Duane Tull, MD. “We are thrilled to have Dr. Bass join our team.” “I’m really pleased and excited to work with a wonderful team that serves an amazing community. I know Oswego Health takes a lot of pride and puts a huge emphasis on patient safety and wellbeing of the Oswego community, and that’s extremely important to me. Cardiovascular disease can have a very negative impact on a community. Prevention and treatment of cardiovascular disease can prolong life, alleviate symptoms of heart disease, and can improve functionality, and help folks live a longer and happier life.”

Health professionals join Crouse Medical Practice Crouse Medical Practice, affiliated with Crouse Health, recently announced the hiring of three professionals. • Physician Charles Miller has joined the cardiology team. An honors graduate of St. George’s University School of Medicine, Miller also graduated with honors from Queen’s Miller University in Kingston, Ontario, Canada, where he majored in life sciences. He served as resident and chief resident at Stony Brook University Hospital in Stony Brook, and completed two fellowships at Tufts Medical Center in Boston: one in clinical cardiac electrophysiology and another in general cardiology.

Miller’s board certifications include those in internal medicine and cardiology from the American Board of Internal Medicine, as well as from the Royal College of Physicians of Canada, of which he is a fellow. He also holds board certification from the Board of Nuclear Cardiology and the National Board of Echocardiography. • Physician Tristan Petrie also joined the practice’s cardiology team. A graduate of Hartwick College with a degree in biology, Petrie earned his medical degree from SUNY Upstate Medical University, Petrie where he served as resident and chief resident in internal medicine. He completed a fellowship in cardiology at Albany Medical Center, and served as a cardiology lecturer there in the physician assistant program. Petrie is board-certified in internal medicine and nuclear cardiology, as well as board eligible in echocardiography and cardiology. Prior to his fellowship in Albany, Petrie was a member of the hospitalist program at Crouse Hospital and the Syracuse Veterans Administration Hospital. His clinical interests are in heart failure, pulmonary hypertension and pericardial diseases. • Nurse practitioner Emily Weston joined the practice’s pulmonary team, downtown location. Weston earned an a master’s of degree in nursing/family nurse practitioner from SUNY Polytechnic InstiWeston tute; a bachelor’s degree in nursing from SUNY Upstate Medical University; and her associate degree from Crouse Hospital’s Pomeroy College of Nursing.

St. Joe’s earns ‘HealthCare’s Most Wired’status

The College of Healthcare Information Management Executives (CHIME) announced that St. Joseph’s Health has earned 2020 CHIME Digital Health Most Wired recognition as a certified level 8 health care system. The CHIME Digital Health Most Wired program conducts an annual survey to assess how effectively healthcare organizations apply core and advanced technologies into their clinical and business programs to improve health and care in their communities.  “We are honored once again to be recognized by CHIME as ‘HealthCare’s Most Wired’,” said Chuck Fennell, vice president for information services and chief information officer

Board-certified Thoracic Surgeon J oins HOACNY David Wormuth, a board-certified thoracic surgeon, has joined Hematology/Oncology Associates of CNY (HOACNY). “As HOACNY continually evaluates changes in the healthcare landscape, a need for a comprehensive thoracic surgery presence in our community was apparent,” says Maryann Roefaro, HOACNY CEO. “To ensure our patients continue to receive the highest level of care for lung disease and cancer, we are excited to welcome Dr. Wormuth to our family of physicians.” Receiving his medical degree from SUNY Upstate and a Master of Public Health degree from the Harvard School of Public Health, Wormuth is board-certified in general surgery, thoracic surgery and clinical informatics. Wormuth’ experience and credentials are vast and varied. Wormuth is the past president of the NYS chapter of the American College of Surgeons and current American College of Surgeons governor, as well as chairman of the Society of Thoracic Surgeons Informatics Task Force. Locallly, he is chairman of the department of surgery at St. Joseph’s Hospital and section head for thoracic surgery at Crouse Hospital. Wormuth also serves as a clinical assistant professor at SUNY Upstate, and as an attending surgeon for all the Syracuse area hospitals, including the Veterans Administration Hospital. Prior to moving to Central New York, Wormuth practiced medicine in Rochester. Thoracic surgeons operate on the organs of the chest, including the esophagus (tube between mouth and stomach), the trachea at St. Joseph’s Health. “St. Joseph’s Health is committed to enhancing connectivity and improving the coordination of patient care across our entire system through innovative advancements in information technology. This is an acknowledgement of the outstanding care provided by our entire health care team.” A total of 29,135 organizations were represented in the 2020 Digital Health Most Wired program, which this year included four separate surveys: domestic, ambulatory, long-term care and international. The surveys assessed the adoption, integration and impact of technologies in healthcare organizations at all stages of development, from early development to industry leading. Each participating organization received a customized benchmarking report, an overall score and scores for individual levels in eight segments: infrastructure; security; business/disaster recovery; administrative/supply chain; analytics/data management; interoperability/population health; patient engagement; and clinical quality/safety. Participants can use the report and scores to identify strengths and opportunities for improvement. Participants also November 2020 •

(airway) and the chest wall (rib cage and breastbone). Thoracic surgery is often used to diagnose or repair lungs affected by cancer, trauma or pulmonary disease. For lung cancer, surgery may remove nodules, tumors and lymph nodes to diagnose, stage and treat the disease. “At HOACNY we have been fortunate to see survival rates from lung and other thoracic cancers continue to rise thanks to advances in early detection and treatment,” said Roefaro. “Adding Dr. Wormuth’s expertise to the HOACNY care team, along with a new Thoracic Nurse Navigator, furthers our mission to providing every patient the highest quality care for healing their body, mind and spirit.” Hematology/Oncology Associates of CNY was established in 1982 and has offices in Auburn, Camillus, East Syracuse and Syracuse and Auburn. The only cancer practice in CNY certified for quality by The American Society of Clinical Oncology, HOACNY also serves as an oncology medical home. received certification based on their overall performance, with level 10 being the highest.  This is the third year that CHIME has conducted the survey and overseen the program. In each successive year, CHIME has expanded the survey to capture more types of organizations that serve patients across the continuum of care. CHIME also continues to promote the program internationally to provide a global overview of digital health advancements.  

Crouse’s spine surgery program earns designation Crouse Health’s spine surgery program has been recognized by BlueCross BlueShield as a ‘Blue Distinction Center PLUS’ hospital. Blue Distinction Centers PLUS for spine surgery are hospitals that are recognized by BCBS for demonstrating safe, cost-effective and efficient care. Facilities are also measured on how efficiently they deliver patient care, based on a set of objective measures. Crouse is one of just nine hospi-

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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H ealth News tals in New York state to receive the PLUS designation for spine surgery

PA joins St. Joseph’s Physicians Women’s Health in Auburn St. Joseph’s Physicians welcomes Melissa Bunce, physician assistant (PA-C) to St. Joseph’s Health Women’s Health Services in Auburn. In her new role, Bunce joins a team of diverse and highly qualified medical profesBunce sionals to provide the most comprehensive women’s care to the community.     A board-certified physician assistant, Bunce brings more than 17 years of clinical experience to St. Joseph’s Health Women’s Health Services. Before joining St. Joseph’s Health, Bunce served as a physician assistant in primary care, internal medicine and HIV medicine at clinics in Arizona and Texas.   Prior to that, Bunce worked in Syracuse as a PA in gynecology, performing patient exams such as pap smears, breast exams, assessments as well as developing suitable treatment plans such as hormone therapy.   Bunce is certified by the National Commission on Certification of Physician Assistants and holds basic life support certification from the American Heart Association. Bunce is also an HIV specialist certified by the American Academy of HIV Medicine.  Bunce earned her master’s degree in physician assistant studies from Le Moyne College and her bachelor’s degree in biology from SUNY Geneseo.

St. Camillus has new director of social services The Centers at St. Camillus has named Mary Wassel its new director of social services. Wassel has been active in the health care field for more than 25 years with a focus on long term care services. She received Wassel her Bachelor of Arts with a concentration in gerontology from SUNY Cortland and was integral to the first Upstate New York student symposium on aging in coordination with SUNY Stony Brook. She received her master’s degree in social work with a concentration certificate in gerontology from Syracuse University and has worked in a variety of aging services. According to a news release, her energetic approach to collaboration and leadership has gained her a Page 26

reputation for being a champion for change. In former positions, she was actively involved with the Delivery System Reform Incentive Payment (DSRIP) program, mutual aid disaster planning initiatives, value based program initiatives, palliative care and quality measure workgroups, as well as other quality initiative programs including GOLDStamp, ETTA and implementation of the INTERACT program. She has served on a number of boards of directors for long-term care providers and was a selected panelist for SUNY Cortland Alumni to speak on careers in health care. Wassel is a 2014-2015 graduate the LeadingAge NY Leadership Academy, where she served as a coach for four years.

Oswego Health promotes laboratory workers Following the retirement of Pat Main, who worked at Oswego Hospital for the past 33 years,, most recently as laboratory administrative director, the hospital announced the promotion of two internal laboratory staff members who will be stepping up to lead the department. • Ed Hale has been promoted to interim administrative laboratory director. He first joined Oswego Health in 1985 as a medical technologist, before advancing to assistant chemistry supervisor in Hale 1989, section supervisor in 1992, and assistant laboratory director in 2011. • Nancy Blais will be the interim assistant administrative laboratory director. Blais started her career in 1995 at Oswego Health as a medical technologist before becoming the laboratory support operations Blais supervisor in 2012.

Heather Elen promoted at Oswego Health Oswego Health recently promoted Heather Elen to human resources operation manager. Elen began her career at Oswego Health in 2016 as a senior recruiter and quickly advanced to recruiting and retention manager in 2017, before becoming Elen employment

IN GOOD HEALTH – CNY’s Healthcare Newspaper November 2020

manager in 2019. In this newly created position at Oswego Health, Elen will focus on overall compensation, benefits, recruiting, employment, reporting, and compliance. “Heather has been instrumental in assisting the department with making various improvements across recruiting, employment, and employee relations,” said vice president of human resources Marq Brown. “In the new role, I’m confident she will help streamline our processes in order to make our department more efficient.” Elen earned her BA in communications from University of Phoenix.

New leadership appointed at Oswego County Suicide Coalition Ashely Taylor, psychiatric inpatient manager at Oswego Health’s behavioral health, has recently been appointed chairwoman at Oswego County Suicide Coalition. The mission of the Oswego County Suicide Coalition is to collaborate with local community members to promote suicide prevention resources, raise awareness, provide support and lower suicide rates in Oswego Taylor County. “The Suicide Prevention Coalition is a group of dedicated community stakeholders who volunteer their time to fight suicide in Oswego County. Ashley has been integral part in leading those stakeholders forward in the betterment of Oswego County residents’ community mental health”, says Prevention Coalition Project Coordinator Tyler Ahart. Taylor holds a master’s degree in human and social services with a concentration on gerontology. She is currently enrolled in a master of social work program. Her goal is to continue to provide education on suicide.

Oswego Health has new director of integrated health Kathryn Pagliaroli has recently been promoted to corporate director of integrated healthcare at Oswego Health. Pagliaroli began her career at Oswego Health in 2001 as a registered nurse in the intensive Pagliaroli care unit and quickly advanced to clinical trainer in 2004, RN case manager in 2008, patient services/staff development manager in 2011, director of quality management in 2013, before becoming director of clinical quality and patient safety in 2014. In this newly created position at Oswego Health, Pagliaroli will provide executive leadership and guidance for care coordination across the healthcare system and operations. She will act as a liaison, in collaboration with senior leadership to develop and sustain a culture that supports access to care across all Oswego Health locations as well as its strategic partners. “Kathryn has been a true asset for Oswego Health and the recent pandemic proved how critical her leadership is to the organization. From managing relationships internally and externally to ensuring access to care for the community, and managing quality of care to patient satisfaction, we feel strongly that Kathryn is deserving of this promotion as she upholds the true mission of Oswego Health,” said Michael Harlovic, president and CEO of Oswego Health. Pagliaroli earned her Master of Science management degree from Keuka College in 2009 and her Bachelor of Science in nursing in 2001 from Roberts Wesleyan College. In 2019, Pagliaroli was selected for a leadership award from the New York Organization of Nurse Executives and Leaders and currently serves

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