IGH - CNY- 237 - September 2019

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All About Addiction Physician Tolani Ajagbe, Crouse’s chief of psychiatry, says addiction is a brain disease — those suffering from it should be able to access care immediately, not be placed on a waiting list

St. Joseph’s Hospital

New U.S. News & World Report’s ranking puts hospital as No. 1 in CNY


personal items you probably should replace today

Medicare for All

A recent survey of 10,000 people shows a divided opinion: 30% support the proposal made by some presidential candidates while 28% oppose it


Back to School

September 2019 • ISSUE 237

n This is usually a challenging time for those within the autism spectrum. Find out why n Medical groups recommend that middle and high schools should start 8:30 a.m. or later. See why n Seven myths about children’s eyes n Asthma, allergies: New school year can bring major flare-ups n All about concussions n Starts on p. 15

Excessive Video Game Playing Now Considered a Disorder P. 20


A person taking the medicinal cannabis derivative cannabidiol (CBD) won’t fail a drug test for marijuana: Study Inside: Drugs such as Benadryl provide little benefit to kids with cold

Please Give Me My Zuchini Find out why SmartBites’ columnist is elated when zucchini season rolls around. “It’s as nutritious as it is delicious,” she says P. 13

More Workers Testing Positive for Drugs P. 4

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

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new study shows that a person taking the medicinal cannabis derivative cannabidiol (CBD) won’t fail a drug test for marijuana — but a person taking the emerging sleep aid cannabinol (CBN) will. These findings were presented in July at the 71st AACC Annual Scientific Meeting & Clinical Lab Expo, and could prevent people from being unfairly penalized for using CBN. CBD and CBN are both cannabis derivatives that have been gaining attention for their ability to confer potential health benefits without causing intoxication. The wellness industry has exploded with CBDbased products that claim to help conditions ranging from anxiety to acne, and last year, the Food and Drug Administration approved the first CBD-based drug for the treatment of severe epilepsy. Though CBN is not as well known yet as CBD, more people are also starting to use it as a sleep aid. According to a news release issued by the AACC, with the popu-

larity of these compounds rising, it is vital for healthcare providers to understand how CBD and CBN interact with screening tests for drug abuse. As just one example of why this is important, certain healthcare institutes do not allow patients to use marijuana if they are taking opioids for pain management. If these patients test falsely positive for marijuana use due to CBD or CBN, they could be unfairly denied their prescriptions as a result. “These findings will help with interpreting drug screening immunoassay results,” said Grace Kroner, Ph.D., of the University of Utah Health Sciences Center in Salt Lake City. “If physicians and laboratorians know a patient is taking CBN, they can consider that if they get a positive from an immunoassay. On the flip side, providers can also be more certain when they get a positive marijuana result that it’s not due to pure CBD oil alone. These results are always assay-dependent, though, so the field needs to keep this in mind.”

Onondaga, Oswego, Cayuga and Madison Counties

CNY’s Healthcare Newspaper

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

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

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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More People Testing Positive for Drugs in the Workplace Workforce drug testing positivity climbs to highest rate since 2004 — marijuana leads the way


he rate of workforce drug positivity hit a 14-year high in 2018, according to a new analysis released in July by Quest Diagnostics, the world’s leading provider of diagnostic information services. Positivity rates in the combined U.S. workforce increased nearly 5% in urine drug tests (4.2% in 2017 versus 4.4% in 2018), climbing to the highest level since 2004 (4.5%) and are now more than 25% higher than the 30-year low of 3.5% recorded between 2010 and 2012. The new findings of the Quest Diagnostics Drug Testing Index were unveiled recently at the Drug and Alcohol Testing Industry Association (DATIA) annual conference in Chicago. “Our in-depth analysis shows that marijuana is not only present in our workforce, but use continues to increase,” said Barry Sample, Ph.D., senior director, science and technology, Quest Diagnostics. “As marijuana policy changes, and employers consider strategies to protect their employees, customers and general public, employers should weigh the


risks that drug use, including marijuana, poses to their business.”

Marijuana dominates Marijuana continues to top the list of the most commonly detected illicit substances across all workforce categories. The rate of marijuana positivity increased in nearly all workforce categories. In the general U.S. workforce, marijuana positivity increased nearly 8% in urine testing (2.6% in 2017 versus 2.8% in 2018) and almost 17% since 2014 (2.4%). For the federally mandated, safety-sensitive workforce, which utilizes only urine testing, marijuana positivity grew nearly 5% between 2017 (0.84%) and 2018 (0.88%) and nearly 24% since 2014 (0.71%).

Positivity rate declines for opioids, heroin and cocaine In the general U.S. workforce, the positivity rate for opiates in urine drug testing declined across all opiate categories. Among the genDiscover

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

eral workforce screening for opiates (mostly codeine and morphine), positivity declined nearly 21% between 2017 and 2018 (0.39% versus 0.31%), the largest drop in three years and nearly 37% decrease since the peak in 2015 (0.49%). Positivity rates for both heroin and cocaine declined in general and federally mandated safety-sensitive U.S. workforce testing Urine drug test results for the general U.S. workforce for heroin, indicated by the presence of the 6-acetylmorphine (6-AM) metabolite, declined 6% (0.033% in 2017 ver-

sus 0.031% in 2018) and more than 16% since its peak in 2015 and 2016 (0.037%). Cocaine positivity declined nearly 7% in urine and more than 19% in oral fluid testing, but increased slightly year-over-year (6.3%) in hair testing. Changes to federal rules for drug testing the federally mandated, safety-sensitive workforce went into effect in January 2018. The addition of four semi-synthetic opiates contributed to the large increases in year-over-year positivity among those workers.

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September 2019 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Sept. 9

Coalition offers fall prevention workshop in Oswego

The Oswego County Falls Prevention Coalition, a multi-agency initiative committed to working together to address the needs of senior residents, is sponsoring its “Stepping On Balance and Falls Prevention” workshop, designed to help participants improve balance and avoid falls. “Stepping On” is an evidence-based program proven to reduce falls in older adults. The program is designed specifically for anyone who is 60 years or older, has had a fall in the past year or is fearful of falling, lives at home and does not have significant memory issues. Classes will cover simple and fun strength and balance exercises, the role vision plays in keeping balance, how medications can contribute to falls, and much more. Participants will leave with more strength, achieve better balance, and experience a feeling of confidence and independence as a result of performing various exercises and sharing personal falls experiences as a group. Research has found that people who complete the workshop have a 31% reduced rate of falls. The workshop runs for two hours, once a week, for seven weeks, at Springside at Seneca Hill in Minetto. It is free of charge and registration is open to the public. Certified instructors from the Oswego County Health Department, Oswego Health Home Care and Bishop’s Commons at St. Luke will lead the workshop. Expert guest speakers provide attendees with valuable information throughout the program. Classes will be held from 1:30 to 3:30 p.m. weekly beginning Monday, Sept. 9 through Oct. 21. Participants

are expected to attend all sessions. Registration is required and space is limited. To register for the workshop or for more information about the “Stepping On” program, please call the Oswego County Office for the Aging at 315-349-3484. Preference will be given to students who are enrolling in the program for the first time.

Sept. 13

‘Senior Moments Resource Fair’ held at Fingerlakes Mall

The Fourth Annual Senior Moments Resource Fair will be held from 8:30 a.m. to 1 p.m., Friday, Sept. 13 at the Fingerlakes Mall, 1579 Clark Street Road, Aurelius, with registration for door prizes at the Savannah Bank entrance. The fair will include a public hearing at 9:30 a.m. where the Cayuga County Office for the Aging will share information about programs and services, and hear suggestions about how it can help address the challenges of aging. At 10:30 a.m., Jessica Strassle of the Cayuga County Veterans’ Service Agency, will provide an overview of the many types of assistance available to veterans, how to determine eligibility and how to apply. At 11:45 a.m., the Cayuga County Office for the Aging and the NY Connects staff present a panel of local professionals experienced in community-based long-term care services, focused on “Aides in the Home: How to Get Them and How to Pay for Them.” The Cayuga County Clerk’s Office will offer veteran discount card and passport applications; to learn what documentation is needed to apply, call 315-253-1271. The Office for the Aging/NYConnects will provide Medicare information, benefits eligibility screen-

ing, and long-term care options. Attorneys from the Boyle & Anderson, P.C. will provide brief senior legal consultations from 9:30 a.m. to 12:30 p.m., and more than 50 vendors will offer information about services available in Cayuga County. The event is free and open to the public. Seniors may request a ride to the event by calling the SCAT Van by Sept. 6 at 315-253-0996. For more information, call the Office for the Aging at 315-253-1226.

Sept. 13

Helio Health celebrates recovery month

Enjoy an evening of delicious food, recovery stories, art exhibits and a silent auction. Helio Health Foundation is organizing its largest fundraisers, “Recovery for Tomorrow.” Held annually in September, the event celebrates recovery month with the “Recovery Arts Exhibit,” live and silent auctions, and the debut of the “Recovery for Tomorrow” video. The event will take place at 6 p.m., Sept. 13, at the Red House Arts Center, 400 S Salina St., Syracuse. All proceeds from this fully catered evening support the Helio Health Foundation and help to raise funds, awareness and hope.

Sept. 14

‘Walk to Defeat ALS’ takes place in Liverpool

ALS Association, Upstate New York chapter, invites the public to join patients and family members and participate in its annual Lowell Smith Circle of Courage Walk to defeat ALS. The event will feature music, food and giveaways. The band, Hand of Fate will perform throughout the event. The one-mile walk will start at 11 a.m. Sept. 14 (Saturday), at Long Branch Park, 3813 Long Branch Road, Liverpool. Check-in starts at 9:30 a.m. Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that affects the function of nerves and muscles. The progressive degeneration of the motor neurons in ALS eventually leads to death. Based on U.S. population studies, more than 6,000 people in

the U.S. are diagnosed with ALS each year. (That’s 15 new cases a day.) It is estimated that at least 16,000 Americans have the disease at any given time. According to organizers, participation in the “Walk to Defeat ALS” has a direct impact on people living with ALS and their families at the local level. Through education, support groups, access to care and advocacy, Upstate New York chapter works to defeat ALS and has provided hope to people living with ALS and their families. In 2018, the Upstate New York chapter provided $168,000 in ALS Assistance and Caregiver Respite grants, loaned 190 durable medical equipment items from regional loan closets, provided 173 home, office, hospital or facility visits, and conducted 22 advocacy meetings and 64 outreach meetings. For more information, contact Monica Shworles, regional development manager at 315-413-0121 or mshworles@alsaupstateny.org.

Sept. 28

Doctors to speak at Amyloidosis Upstate meeting

The Amyloidosis Upstate NY support group will host four physicians during its meeting from 8:30 a.m. to 1:30 p.m., Sept. 28, at Wilmot Cancer Institute, 601 Elmwood Ave. in Rochester (conference center on the second floor). The nearly all-day meeting will provide participants with light breakfast and lunch and a discussion about the latest on amyloidosis (amy-la-dosis), a blood protein disease originating in the bone marrow that are abnormally formed, traveling through the blood stream and depositing in one or more organs, which leads to organ failure. The guest-speaker physicians are Anita D’Souza, Frank Passero, Himabindu Vidula and Ronald Schwartz. Patients, caregivers, family members and interested medical personnel are urged to attend. For more information call or email Maryann Kraft, thumbelinamk@yahoo.com, 585-334-7501; Paula Schmitt, paula@ amyloidosissupport.org or 866-4047539. For more information, visit www.amyloidosiossupport.org.



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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Your Doctor

By Chris Motola

Tolani Ajagbe, M.D. Crouse’s chief of psychiatry says addiction is a brain disease with several components — those suffering from it should be able to access care immediately Q: You’ve been doing a lot of work with addiction in the CNY community. How did it become a focus within your practice? A: Two major reasons. I went to school at SUNY Upstate Medical University. I did my postgraduate training in psychiatry at Upstate, so during that time I had a lot of exposure to people who were suffering from addiction. I developed a lot of passion for this very critical under-served and often stigmatized community. Also, I have some background interest in addiction because I lost a first cousin of mine who had an alcohol addiction. He died from complications of that addiction. So, I felt I should channel that to help people suffering from that disease. Q: What is addiction from a medical perspective? A: Addiction is basically a brain disease. In the past, before we better understood the neuroscience of addiction, we treated it as some sort of failure or shortcoming. What research has shown over the years is that it’s a brain disease with a lot of components. There’s a biological component. A genetic component. There’s a psychological component to it. There’s a behavioral component to it. They all come together to greatly affect a patient’s ability to function. So it is actually by some definitions “a compulsive use of a substance or drug despite suffering repeated harm.” So the life of people suffering from addiction has been rendered unmanageable. They lost their homes, lost their friends, lost their families. They may have legal troubles. And in spite of all this, they’re not able to stop using the substance.

A: The reason why it’s so difficult to be able to beat that disease is multifaceted. Approximately 50% of the risk for addiction is genetic, so some people are born predisposed to developing an addiction, all they really need is to be exposed to the substance for which they are predisposed. A lot of people experiment with drugs, but most people don’t end up addicted, but the ones who are predisposed can get addicted. The second part is brain development. A lot of that experimentation may happen at a time the brain is going through critical changes. So exposure to drugs at that age can cause a lot of disruption in the neural development of the brain, and the brain may end up dependent on that substance. Then, later in life, when they try to come off those drugs, they find that they may not be able to function without the substances in their system.

Q: Why is addiction so resistant to treatment?

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

Q: The big addiction crisis right now is, of course, opioid addiction. What additional factors have made it such an epidemic? A: There are multiple levels. This is actually the third major opioid crisis we’ve had, historically. We had the heroin crisis in the late ‘70s, early ‘80s which fizzled a bit after a while until big pharma came in the ‘90s and started marketing oxycontin as a pain medication. So there was a lot of aggressive marketing and pressure on doctors, despite initial reservations, to recommend this wonderful opioid that made all pain go away. Then in the early 2000s there was this idea of pain being the fifth vital sign, where emphasis was put on how to control your patient’s pain. So doctors were prescribing opioids a lot at that point. By 2010 a lot of opioid addiction and opioid-related deaths started being noticed that were attributed to these pills. A lot of aggressive strategies were being put in place to curtail what was going on. In New York, we have a database where all doctors can go to see if a patient is getting any controlled medications. So a lot of medical and law enforcement strategies were put into place to deal with the supply and demand for the drugs. Q: How effective were they? A.: Unfortunately, we’d already created a lot of opioid-dependent patients, many of whom suffer from chronic pain. Many of them started buying opioids off the streets. And at some point, it gets too expensive to buy prescription pain killers off the streets, so many turn to heroin. Then around 2013 a big killer — fentanyl — arrives, much of it coming from outside the country. It’s another animal. Very dangerous, very addictive, very easy to produce and transport and it’s cheap. And the people who make it are constantly finding new ways to make it more potent, more addictive. It’s also easily mixed into other drugs: heroin, cocaine, molly, ecstasy. So we’ve seen the number of deaths related to fentanyl rising steadily since then. In 2017, the CDC recorded over 70,000 overdose-related deaths that year. Somewhere around 39% of them were from fentanyl. Q: What are some of the challenges to getting people to view addiction in medical terms rather than moral or criminal ones? A: It’s very difficult because we’re set in our ways. The science of addiction has evolved a lot over the past few years. Part of the presentation of addiction is behavioral so people will tend to see it as behavioral issue and go for the most reductive explanation: they’re just bad, just poorly raised. Sometimes we go for the cheap road that just makes us feel better about ourselves. And it doesn’t work. They’re used to being called names. The moment they’re seen as an addict, they’re treated differently. Many of them withdraw into their shell, which makes it harder for them to seek help. It’s not like telling someone you’re having chest pains. These things affect

“I have some background interest in addiction because I lost a first cousin of mine who had an alcohol addiction. He died from complications of that addiction. So, I felt I should channel that to help people suffering from that disease.” them in ways most people won’t even understand. There are so many aspects to it. The other issue is access to care. Q: What are some of the issues with access? A: I’ve had conversations with my patients where they’ve said that often, when they’re struggling, they’ll wake up in the morning and they have only two thoughts: “I need to get help today,” and “I can’t do this anymore.” There are different ways they got there. Sometimes they spent all their money, lost their homes, lost their jobs. Or they think maybe they need to commit suicide to put an end to it. Most of the time they don’t do either of those two things. When they try to get help, they encounter waiting lists. Even my program we used to have a waiting list that lasted up to a year and a half. Or, if they go to the emergency room, they’ll get medicine that treats their anxiety but doesn’t really help their problem. So we’re trying to find ways to help patients access care immediately and making treatments like Suboxone available in the ED here at Crouse. We also have a same day access program available through outpatient clinics. And the third part is making funds available to different programs, because addiction isn’t just a biological problem you treat with medicine. There are psychological issues, social issues, employment issues, homelessness, legal issues, additional health care issues. So there are so many other aspects of addiction that need to be addressed to make treatment successful.

Lifelines Name: Tolani Ajagbe, M.D. Position: Chief of psychiatry and

medical director, chemical dependency treatment services at Crouse Health Hometown: Ibadan, Nigeria Education: University of Ibadan; SUNY Upstate Medical University Affiliations: Crouse, SUNY Upstate Organizations: American Academy of Addiction Psychiatry; American Society of Addiction Medicine; American Psychiatric Association Family: Wife, three children (16, 14 and 12 years old) Hobbies: Billiards, travel

4 Personal Items You Probably Should Replace Today


s your toothbrush more than four months old? And how about your contact lens case? These and other everyday essentials need regular replacing, no matter how comfortable you are with them. At the top of the list is your toothbrush. To benefit oral health, your toothbrush needs to be in tiptop form. The American Dental Association suggests replacing it as soon as bristles start to fray, usually every three to four months.

If you wear contact lenses, you should replace your contact lens case every three months, sooner if you see any cracks, which can harbor bacteria. For proper care, after putting your lenses in your eyes, rinse the

by your eye care professional. If you’re like many Americans, you probably don’t use as much sunscreen as you should. That could mean leftover product once summer ends, season after season. The U.S. Food and Drug Administration requires sunscreens, like other nonprescription drugs, to have an expiration date unless testing conducted by the manufacturer has shown that the product will remain stable for at least three years. So don’t use sun-

screens after their expiration date or, if there’s no date, if purchased more than three years ago. The hardest item to let go of could be in your bedroom — your pillow. There are no hard and fast rules about when to toss an old pillow, but the National Sleep Foundation suggests every one to

two years, especially if it hasn’t been protected from dust mites with a zippered cover. (Consider getting one for your next pillow.) Washing helps, but check label instructions before tossing a pillow into the washing machine — some won’t survive the spin action.

case with fresh lens solution, shake out excess liquid, and leave the empty case open to air dry. P.S.: Don’t keep contacts in your eyes for longer than they’re designed to be worn, and always replace them according to the schedule prescribed

Healthcare in a Minute By George W. Chapman

Medicare for All: 30% Support it, 28% Oppose it


ith a national election next year, the subject of healthcare dominates debates, news and talk shows. Medicare for All, universal coverage and single-payer models are being touted. The Urban Institute recently surveyed close to 10,000 people about their thoughts on healthcare. When asked about a “single payer” system, 41% responded they neither supported nor opposed the concept. But when asked about “Medicare for

Best states for healthcare WalletHub has ranked the five states and DC, from best to worse, for healthcare. Rankings were based on a variety of factors including availability, access, cost and outcomes. The top five states beginning with No. 1 are: Minnesota, Massachusetts, Rhode Island, District of Columbia, and Vermont. The bottom five states beginning with No. 47 are: Arkansas, South Carolina, Mississippi, North Carolina and Alaska. New York ranked in the middle at No. 24. Notably, four of the top five states are in the northeast, while four of the five worst states for healthcare are in the southeast.

Telehealth growing slowly

According to a survey by J.D. Power, patient usage or acceptance of telehealth services is growing slower than envisioned. Just under 10% of those surveyed said they used telehealth in lieu of an onsite visit to a physician, urgent care center or emergency room. J.D. Power, known for rating cars, is going to set benchmarks for patient satisfaction later this year so they can measure consumer satisfaction with telehealth.

All,” 30% were in support and 28% opposed. (Medicare for All is a single payer system.) Forty-five percent of the respondents said they do not support or oppose a “public health option.” while 32% would support it and 21% would oppose it. The obvious problem here is healthcare is very complicated and often confusing. Consequently, the majority of Americans are ambivalent about the various models of care and are understandably fearful of change. Fifty-six percent of those surveyed said they would be more inclined to use telemedicine if there was some sort of ranking or satisfaction measurements. Most of those surveyed weren’t sure whether or not their insurance covered telehealth. Only 17% were sure either way. Most insurers cover telehealth, but are reluctant to “sell” it fearing over utilization of medical services. The survey produced six key findings. 1. Almost half of the respondents thought the quality of care would be diminished via telehealth. 2. Lack of awareness is most pronounced in rural areas (72%) where telehealth makes the most sense. 3. None (0%) of the patients indicating they are in poor health used telehealth. People in good or better health are more likely to use telehealth. 4. Consumers aren’t sure what it costs. 5. Consumers are split on whether telehealth is more or less as personal than an onsite visit with a provider. 6. Telehealth is used more out West (11%) than here in the East (6%).

Opioid deaths decline

For the first time in 30 years, deaths due to opioid abuse actually

fell about 5% from approximately 72,000 in 2017 to approximately 68,000 in 2018. A decline in prescriptions for opioids was an obvious factor in the recent decline in deaths. Despite the decline, the number of 68,000 unnecessary deaths is still unacceptable. The CDC contributed to the decline in deaths by clarifying opioid prescribing guidelines for providers. Success varies by state. Sixteen states had more deaths in 2018 versus 2017. Two states with the worst drug problems fared far differently from each other. Missouri opioid overdoses increased 16% while New Hampshire experienced a 7% decrease in deaths.

Best NYS hospitals

Per U.S. News and World Report, three of the top six are in New York City: Presbyterian-Columbia, Mount Sinai and Lenox Hill. Two are on Long Island: St. Francis and NYU Winthrop. The sixth is Strong Memorial in Rochester.

Most common medical conditions

If you have been to your doctor’s office lately, your chief medical complaint or condition was probably from the top 10. They are in no particular order: skin disorders, stiff joints, bad back, high cholesterol, upper respiratory infection, anxiety/ depression, chronic neurological disorder, high blood pressure, headaches and diabetes.

Climate anxiety/grief

The clinical term is “solastalgia”. Unfortunately, it is on a precipitous increase worldwide. It is defined as the distress or anxiety produced by environmental change impacting people while they are directly connected to their home environment. The American Psychiatric Association has produced a climate change September 2019 •

guide to help physicians and mental health providers diagnosis and treat. Rising temperatures have actually led to more suicides. It is estimated that climate change contributes to 250,000 deaths per year worldwide.

Gun violence prevention

Medical professionals are speaking out, again. In the aftermath of several mass shootings, several physician associations co-authored an article in the Annals of Internal Medicine calling for immediate action to prevent gun violence. Gun violence is now acknowledged as a public health risk. The article was sponsored and written by the heads of: American College of Physicians, American Academy of Family Physicians, American Academy of Pediatrics, American College of Surgeons, American Medical Association, American Psychiatric Association and the American Public Health Association. Some of the recommendations include: enactment of “red alert” laws which allow judges to temporarily remove firearms from individuals at risk to do harm to others or themselves; requiring comprehensive criminal background checks; encourage research into the causes of gun violence and recommendations to reduce; improving access to mental health care; supporting physicians on how to advise families and at risk patients about potential gun violence and how to mitigate the risk. George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 9

Live Alone & Thrive

inside you? Set it free! Treating yourself well builds self-esteem. Prepare and enjoy healthy meals at home. Get enough sleep. Walk, move or exercise every day. Stay engaged with others and your community. Pamper yourself. You’re worth it. Do it! Living alone takes practice. Know that there is always someone you can call or something you can do to improve your situation. Getting out of your comfort zone is worth the discomfort. Try something new — pick up a musical instrument, take a memoir-writing class, learn a new language, start a book club, explore a plant-based diet — whatever piques your interest. It’s a great way to stretch yourself and meet others along the way. Isolating on holidays, birthdays, Sundays, etc. is for the birds. Solitary confinement is punishment for criminals, not single people. Make plans. Comb your hair. Lose the baggy sweatpants. Put a smile on your face. It’s important to create your own positive feedback. Caring about your appearance says a lot about how you value yourself. Traveling solo can lead to self-discovery and grow your self-reliance. Whether it’s Paris or Peoria, striking out on your own will expand your horizons, build self-awareness and increase your appreciation for diversity. You will become a more interesting person, not only to yourself, but to others as well. There’s no shame in asking for help. It’s not a sign of weakness. On the contrary. Asking for help shows confidence and resourcefulness. If feelings of fear, vulnerability or self-doubt overcome you; a little quiet time, meditation, and/ or prayer can be an answer. Embrace your spiritual side, however that

manifests itself in you. Your dream house can be yours. Whether it’s a cozy apartment or cottage in the country, you can — at long last! — make your home your own. Expanding your definition of love beyond “romantic love” will stand you in good stead. Embrace “passionate friendships” — those relationships in which you can be yourself and feel completely comfortable. It’s all yours — the good, the bad, the chores, the bills. Living alone, like married life, is not Shangri-La. It’s real life. And that’s a beautiful thing. Embrace it. Still in your PJ’s at noon? No one needs to know.



This We Know: 25 Things Living 12. Alone Has Taught Us


By Gwenn Voelckers

Practical tips, advice and hope for those who live alone


his September marks the 14th anniversary of my solo trip to Paris to celebrate turning 50. It also marks the anniversary of a decision I made that changed my life. It was in the “City of Light” that I decided to create a workshop designed to help women live on their own with more confidence and joy. Since launching the workshop in 2005, I have met and been inspired by countless courageous and resourceful women (and men, too) who are now living alone with success. They reinforce what I practice every day and what I “preach” in this column and my “Alone and Content” workshops — that the relationship with ourselves is the most enduring of all and worth nurturing. While many of the women and men I’ve met have encountered some very real and painful obstacles, they now embrace their independence and are busy leading interesting, full lives. They are making it on their own. These independent pioneers have discovered, as have I, that marriage is not the only state in which we can be truly happy, fulfilled, secure and complete. Whether divorced, widowed or “confirmed” bachelors or bachelorettes, they are not spending their time bemoaning their fate. They have taken their lives into their own hands and have come to appreciate the choices and opportunities that living alone has to offer.

This we know:

existing friendships, make new and interesting connections and spend quality time with family members. Loneliness is not a state of being reserved for single people. Did you ever feel lonely or neglected while being married or in a committed relationship? With time alone, spent with intention, you can re-awaken your true self and identify those things that bring you joy. When that happens, living alone can become a profound adventure of the spirit. The stereotypical image of single women and men as desperate and miserable are exaggerated and just plain untrue. Recent studies on the subject bear this out. Accepting party invitations is worth doing, even if you suspect the party will be mostly couples. Remind yourself that guests often separate into groups of women and men, so singles blend right in. Figuring out how to hire a contractor, buy a car or even replace the flapper valve in your toilet — all by yourself — can be very satisfying! Pursuing a new career, volunteer job or college degree in midlife can be liberating and rewarding. Doing a random act of kindness is a great antidote when you’re feeling alone or sorry for yourself. Despite past hurts, try your best to remain open to others who would like to get to know you. Relationships can add dimension and meaning to your life. That said, responding “yes” to a dinner date does not obligate you to anything. Living alone can release your inner Martha Stewart. Do you have a craft project secretly lurking








7. 8. 9.

Drugs such as Benadryl provide little benefit to kids with cold

Hanging out with negative 23. people is a real downer. Put yourself with upbeat people who


Are Too Many Kids Prescribed Antihistamines?

Page 10



s d i K Corner




Living alone doesn’t mean being 10. 1. alone. In fact, it can offer more time and opportunities to deepen

any U.S. doctors are much less likely to recommend cough and cold medicines for young children ever since experts advised against it in 2008, new research shows. That’s the good news. The bad news? Physicians are still more likely


to recommend antihistamines for children under age 12 with colds, despite the fact that they provide little known benefit, the researchers from Rutgers University in New Jersey said. “Sedating antihistamines such as diphenhydramine [Benadryl] may have a small effect on some cold

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

17. 18.

symptoms in adults,” said study lead author Daniel Horton. He is a physician and assistant professor of pediatrics at Rutgers Robert Wood Johnson Medical School. “However, there is little evidence that antihistamines actually help children with colds feel better or recover faster. We do know that these medicines can make kids sleepy and some kids quite hyper,” Horton said in a university news release. Just over a decade ago, the U.S. Food and Drug Administration recommended against cough and cold medicines for children under age 2 due to safety concerns and uncertain benefits. The American Academy of Pediatrics later advised against cough and cold medicines in children under age 6. “Families often treat their children’s respiratory infections with cough and cold medicines, some of which include opioid ingredients, such as codeine or hydrocodone. However, there is little proof that these medications effectively ease the symptoms in young children,” Horton explained. “Also, many cough and cold medicines have multiple ingredients, which increases the chance of serious

make you feel good about yourself and about life. Mac and cheese may be just what the doctor ordered. There’s no harm in occasionally indulging in your favorite comfort food and tear-jerky movie. “The Way We Were” is my three-hankie movie of choice. Finding your home in your heart can deliver peace as well as power. Harness that potential and your contentment will know no bounds. Don’t we know it!

Gwenn Voelckers is the founder and facilitator of “Alone & Content” empowerment boot camps for women held throughout the year in Mendon. She is the author of “Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own.” For information about her boot camp, to purchase her book, or invite her to speak call 585-624-7887, email gvoelckers@rochester.rr.com, or visit www.aloneandcontent.com accidental overdose when combined with another product,” he added. In the study, the researchers analyzed more than 3 billion visits by children to U.S. clinics and emergency departments from 2002 to 2015. They found that physicians ordered a total of about 95.7 million cough and cold medications, 12% of which contained opioids. After the FDA’s advisory, there was a 56% drop in physician recommendations for non-opioid cough and cold medicines in children under 2 and a 68% decrease in recommendations for opioid-containing medicines in children under 6. Yet the researchers also found a 25% increase in doctor recommendations for antihistamines to treat respiratory infections in children under 12. “It is nice to see physicians are heeding the advice to avoid cough and cold medications for children, but switching them to antihistamines is not necessarily an improvement,” said study co-author Dr. Brian Strom, chancellor of Rutgers Biomedical and Health Sciences. The study was published July 29 in the journal JAMA Pediatrics.

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CNY Doctors Team Up to Reduce Opioids in the Region By Payne Horning


t’s custom at Oswego Health for patients who undergo surgery to receive a call from a physician or nurse one month out from the operation. It’s a checkup to see how they are feeling and to learn about any potential complications. Last year, a new question was added to this list for those patients who had been prescribed opioid medication to manage the postoperative pain. “How much of the medication did you actually use?” The answer was unexpected. “It was really eye opening when we followed up with the patients and found that over half of them were not using all of the medication that had been prescribed,” said Lisa Annenberg, surgical quality management specialist at Oswego Health. Annenberg says this was disconcerting for two reasons. It revealed that many of the opioid pills making their way out into the community were unnecessary. And even more troubling, this was happening at a time

when county wide data showed a real problem with opioid prescriptions per capita in Oswego County and overdose deaths related to opioids. The issue, as it turns out, was not limited to Oswego County. The entire region was struggling with the same problem. So, a group of surgeons and nurses came together to collaborate on a solution. The result was the creation of a set of best practices and prescribing guidelines for patients who have undergone any one of 21 different procedures. “It’s all about responsible prescribing,” Annenberg said. “The overall goal for all of us involved in health care when it comes to the opioid crisis is to reduce the number of opioids available for diversion, to make sure that the opioids being prescribed are actually needed.” The procedures targeted range from knee replacement to incision-less surgery for bladder tumors. It’s been adopted by surgeons at 18 hospitals and health centers in Upstate New York, including Oswego Health,

St. Joseph’s Health Hospital and Upstate Medical University. Excellus BlueCross BlueShield is also contributing to the effort through its data analytics. Although the goal is to cut down on the number of opioids making their way into the community overall, the guidelines are not mandatory. Katie Pagliaroli, director of quality and patient safety at Oswego Health, says the group has committed to providing patient-centered care so people who need more assistance managing their pain are not limited, such as those with chronic pain. The surgeons still make the final call on how much to prescribe and there is a mechanism built into the program where patients can be reevaluated if the amount of medication ordered was insufficient. “The guidelines are just those — guidelines,” Annenberg said. “We look at the guidelines to reduce the number of postoperative opioids, but individually, prescriptions have to take into account the patient’s needs.” In addition to the new prescription guidelines, Oswego Health is working

to reduce the number of opioids in the county through a drug takeback initiative. The hospital successfully applied for a grant to put in a drug take back box that’s accessible to the public. The secure collection bin is located just outside the entrance to Oswego Hospital’s emergency department on West Seventh Street, open 24 hours a day. Pagliaroli says tackling this problem as a group will not only curtail a larger amount of opioids pouring into the region but also improve the project’s approach. The participating hospitals and health centers will continue to meet periodically to review data and analyze the success and shortcomings of the program. “As time goes on, we learn a lot about what does work and what doesn’t and that’s why it really truly is a science because we don’t always have a crystal ball to foresee the future,” Pagliaroli said. “But I think when we work together in a large enough group with other hospitals, that helps us learn even more.”

Marijuana Use by U.S. Teens Jumps tenfold Since 1990s


s society relaxes its rules around marijuana, U.S. teens seem to be responding by using the drug in much bigger numbers than a generation ago, new research shows. The study looked at 1991-2017 U.S. federal health data on more than 200,000 high school students. It found that the number who said they’d used pot at least once over the past month rose ten-fold — from 0.6% in 1991 to 6.3% by 2017. Many are becoming “dual users” of both marijuana and alcohol: The number of teens who admit to using both substances at least once a month has almost doubled — from 3.6% in 1991 to 7.6% in 2017. Why these big changes? Study author Hongying Dai believes changing social mores and legislation has been a big factor. “Public opinion on marijuana use have changed dramatically, and restrictions on marijuana use have been relaxing,” wrote Dai, of the University of Nebraska’s College of Public Health

in Omaha. “Currently, 33 states and the District of Columbia have laws in place that allow marijuana to be used medically, recreationally, or both.” There was some good news from the study teens are increasingly turning away from cancer-causing cigarettes and other combustible tobacco. According to the study, teen smoking has dropped from 4.4% of high school students in 1991 to just 1.3% today. Teens are drinking much less, too, with alcohol use falling from about 24% of teens in 1991 to 12.5% in 2017. Still, the “surge” in marijuana use is troubling, Dai said, and “highlights the importance of marijuana prevention among youths.” She added that usage rates increased most dramatically among black and Hispanic youth. Over the time period covered by the study, use of marijuana by black teens soared from 2% to 13.5%, and from less than 1% to nearly 9% among Hispanics. In comparison, in 1991 0.3% of white teens said they’d used pot over the past month, and 3.7% said so by 2017. September 2019 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 11

Men’s Health

Sperm Banking Helps Men Protect Fertility By Deborah Jeanne Sergeant


hile many men can become parents much later in life compared with most women, sperm banking may provide a means for men to preserve their fertility for a variety of reasons, one of which may be impending older age. JC Trussell, urologist and associate professor of urology at Upstate Medical University, said that that older dads have a “minimally” higher risk of genetic problems with their offspring; however, the greater risk is that of miscarriage. “The literature says after 40 to 50 years of age, a healthy pregnancy be-

comes more difficult,” Trussell said. “The sperm gets a little more DNA damage. Also, they tend to have older partners.” Urology offices can perform a semen analysis of sperm and help men improve their chances of fatherhood, he said. Trussell advises men anticipating chemotherapy or radiation to the testicles, and those engaging in higher risk activities or employment should consider freezing sperm. Physician Rob Kiltz, founder of CNY Fertility based in Syracuse, said that although men’s fertility doesn’t

DRIVERS WANTED We’re looking for dependable people to help us distribute copies of In Good Health, CNY’s Healthcare Newspaper, in offices and other high traffic locations in the region. Great for active retirees or at-home moms in need of some extra cash. Not a regular job — work only one or two days a month during office hours (9 to 5). Compensation: $11.10/h plus 30 cents per mile. It amounts to about $150 / $250 per distribution, depending of the route.The paper is usually distributed at the beginning of the month. Drivers pick up the papers either in Oswego or Liverpool and leave copies at various locations, following a list of places we provide. No heavy lifting. Drivers are required to have a dependable vehicle, be courteous and reliable. We audit all areas of distribution.

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

decline as much as women’s, other factors have in general caused male fertility to change. “Men more and more are being exposed to environmental factors, diabetes, autoimmune diseases, cancers that affect fertility even before they have a chance to bank sperm,” Kiltz said. “It may be more reasonable to bank sperm in their early- to mid-20s before these things happen.” Kiltz said that over the past 20 years, the quality of sperm has been changing, along with the shift of couples delaying children until their later 30s. As a result, more men find it difficult to father children. “Many of the sperm abnormalities are related to morphology and function and DNA fragmentation and it’s only picked up on because the guy is infertile,” Kiltz said. “It might be that we don’t even notice these things sooner because no one is trying to get pregnant up to that point. These things may be factors that if you had preserved your sperm in your early 20s, you maybe could have avoided.” Other factors may prompt men to consider sperm banking as young men. Some couples want permanent contraception and choose vasectomy; however, reversing vasectomy should they change their minds can be difficult and not always successful. Reversal also costs quite a bit of money — $5,000 to $20,000, according to several websites — and isn’t covered by insurance. “More and more men should consider sperm freezing because of the issues they encounter that can affect their sperm,” Kiltz said. “Banking is more affordable than people think.” He said that sperm banking costs a few hundred dollars initially and about $3,000 to store for 10 years. “If a man is considering a vasectomy or permanent form of contraception, freezing sperm may give him opportunities to have children without a reversal or IVF,” Kiltz said. “A lot of men and women think they won’t want children when they’re young and want a form of contraception that won’t fail but if they change their mind in the future, they can use banked sperm rather than have a reversal.” Employment or medical that exposes men to toxic chemicals, radiation or physical damage to the testicles should also consider sperm preservation. Kiltz said that the success rate of conception is “very high” with sperm saved through cryopreservation. Boys who experience cancer therapy before puberty can still preserve their chances of fatherhood. Kiltz said surgeons can remove testicular material and after their cancer treatment, it can be implanted again to allow them the opportunity to generate sperm. In general, men can improve their chances of healthy sperm by avoiding drugs — including marijuana — alcohol, and smoking. Kiltz said that for diet, he promotes a “keto/paleo diet.” He also believes it’s important for men to slow down. “Enjoy more easy living and less treating your body like you live in a carnival,” he said. “Treat it like a temple.”

Overweight Men May Feel Stigmatized, Too


t’s not only women who agonize over their excess pounds. Stigma about being overweight can cause physical and emotional harm to men, too. “It’s often assumed that conversations about weight loss, poor body image, and dieting are more salient for women. Men are frequently overlooked, but that does not necessarily mean that men are less affected by weight stigma or less likely to internalize negative biases,” said Mary Himmelstein, lead author of a new study from the University of Connecticut, in Hartford. As many as 40% of men report weight-related stigma, meaning they’re discriminated against or stereotyped because of their size. But there’s been less research on how it affects their health compared to women, according to the researchers. For the study, the investigators surveyed more than 1,750 men across the United States. The researchers found that weight-related stigma (both internalized and from other people) was associated with higher rates of depressive symptoms and dieting. Men who experienced weight stigma were more likely to binge eat, and men who internalized weight stigma had lower self-rated health, the findings showed. The study was published online July 31 in the journal Obesity. The findings show the need for researchers and health care providers to pay more attention to weight stigma and health in men, Himmelstein and colleagues said in a university news release. For example, asking men about weight stigma may help doctors identify those who may be at risk for depression or eating disorders — conditions that are underdiagnosed in men. “Our study shows that weight stigma is not a gendered issue. It can affect men’s health in the same damaging ways in which we already know that it harms women’s health, and neglecting these issues in men, either in research or clinical practice, may put them at a serious disadvantage in treatment,” Himmelstein explained. Supportive interventions should be available for men, women, and people whose gender is not male or female to help them cope with weight stigma in less harmful ways, she concluded.


The skinny on healthy eating

Lose Weight, Improve Skin with Zucchini Y ears ago, when gardening friends left baskets of zucchini on my front porch, I used to get so rattled. Blind to its taste, ignorant of its nutrition, I’d fret over what to do with the unwelcome lot. But now that I’ve become zucchini-savvy, I’m genuinely elated when zucchini season rolls around. I adore this versatile summer squash! It’s as nutritious as it is delicious. Similar to watermelon, zucchini’s most bountiful nutrient is water: 95%. This all-important nutrient helps to regulate temperature, promote healthy digestion and curb constipation by producing softer stools. And while zucchini doesn’t have the fiber content of, say, peas or broccoli, it’s got enough to help move things along by producing bulkier stools. Zucchini teems with vitamin C, with one small zucchini providing close to 40% of our daily needs. A powerful antioxidant and immune-booster, vitamin C is certifiably our skin’s best friend: it helps keep skin strong and firm by triggering the production of collagen; it helps prevent sun damage by neutralizing

damaging free radicals; and it promotes wound healing. Some say you can even use zucchini to treat puffy eyes by placing raw slices over your eyes for 10 minutes. Feeling blah? Reach for some zucchini! Because zucchini provides healthy doses of many B vitamins, especially vitamin B6, it can help boost energy production and reduce fatigue. What’s more, vitamin B6, which is involved in the production of mood-elevating serotonin, may also help regulate sleep and lift spirits. And, like most plant-based foods, zucchini is packed with antioxidants, those magical molecules that minimize cell damage that may lead to heart disease, cancer, macular degeneration, and other age-related diseases. Research indicates the highest levels are found in the zucchini’s skin and that yellow zucchinis may contain slightly higher levels than green ones. Finally, regular consumption of zucchini may help you lose weight. Rich in water and fiber and yet low in calories (only 40 per small zuc-

By Anne Palumbo chini), zucchini may help you feel full longer and reduce hunger—potentially leading to weight loss over time.

Zucchini “Noodles” with Sesame-Peanut Sauce

Adapted from Fat-Free Vegan Kitchen

3 small zucchini (or, one package of fresh zucchini noodles) 1 red bell pepper, julienned 2 tablespoons peanut butter 2 tablespoons water 1 tablespoon cider or rice vinegar 1 tablespoon soy sauce 2 – 3 cloves garlic, minced ½ - 1 teaspoon Sriracha or hot sauce 1 teaspoon sesame oil 1 teaspoon grated fresh ginger Salt and pepper to taste Wash zucchini; trim ends. Use a spiralizer to turn zucchini into “noodles.” Line a large bowl with paper

Helpful tips:

Select small- to medium-sized zucchini with shiny, unblemished skin; it should feel firm and heavy for its size. Smaller zucchini tend to taste better. Don’t cut up or wash zucchini until ready to use. Store it in a loosely closed plastic bag for up to one week. Leave the rind on whenever possible: it’s loaded with nutrients! towels; place zucchini noodles in the bowl along with the julienned red bell pepper. Let rest 10 minutes. In a small bowl, whisk the peanut butter with the water until well combined; then mix in all the remaining ingredients. Taste and adjust seasonings. Remove the towels from under the zucchini. Add the sauce and stir well to coat the noodles completely. Serve immediately, garnishing it with fresh basil if desired. (Optional: Add a legume such as edamame or black beans to make it more filling.)

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.

1 IN 10 CHILDREN IS AFFECTED BY ASTHMA BE PREPARED. The return to school is tough for

kids with asthma. Because they head straight into peak virus season and may be exposed to new triggers, they’re more likely to have an asthma attack. Make sure you have an action plan.

September 2019 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 13

My Turn All You Need to Know About Concussions By Eva Briggs

There isn’t any specific medicine to treat concussions but over-the-counter pain relievers and sometimes medicines for sleep or anxiety can help.


ild traumatic brain injuries, also known as concussions, occur anytime of the year. However, as kids return to school and sports this fall, I’ll be seeing more head injuries at the urgent care. There is no one universal definition of concussion. Most definitions state that a concussion is caused by direct or indirect force to the brain, producing neurologic symptoms, not explained by some other cause. So first, the direct injury to the head, face or neck must occur shortly before the onset of symptoms. The neurologic symptoms usually start right after the injury, but can evolve over minutes to hours. Symptoms can be physical, cognitive (thinking and reasoning), emotional or behavioral. Physical symptoms include blurred vision, dizziness, fatigue, headache, lightheadedness, sensitivity to noise and light, nausea, numbness and tingling, ringing ears and vomiting.

Cognitive symptoms include confusion, amnesia, trouble concentrating or memory, disorientation, feeling slow or foggy, trouble focusing, loss of consciousness and slurred speech. Examples of emotional and behavioral symptoms include sleep disturbances, drowsiness, anxiety, cleanness, irritability, sadness, and personality changes. Concussion arises from forces that disrupt nerve cell membranes. This allows potassium to flow out of the cells into the extracellular space, and also permits increases in calcium and certain amino acids to leak out of brain cells. As the body attempts to restore balance, blood flow to the brain may decrease. These disruptions can persist for several weeks. During this time the brain has increased susceptibility to damage from any further injury. Because these changes occur at the microscopic level, imaging test like CAT scan or MRI are not needed,

and indeed don’t show abnormalities. Medical providers only order these tests when symptoms suggest structural damage to the brain. Most children who have a concussion do not need a CAT scan, which exposes the brain to unnecessary radiation with its potential long-term consequences. Recovery from concussion can take days, a few weeks or even months. Some patients’ symptoms resolve within 72 hours. Most adults recover in about two weeks and children take one to three months. But for some people concussion symptoms persist longer. Unfortunately, there is no way to predict which patients will have a prolonged recovery. Loss of consciousness and amnesia, and other symptoms are not clearly associated with the length of time it takes to get better. In general, the more severe the initial symptoms, and a history of prior concussion, portend slower recovery. Symptoms of fatigue, early onset headache, amnesia, disorientation, also are associated with prolonged recovery. After an initial evaluation, concussion patients can return home with a responsible caretaker when medically stable and have access to follow-up medical care. The first stage of recovery is cognitive rest for 24 to 48 hours. This translates to avoiding activities that require attention or concentration: text messaging, video games, television, computer use and schoolwork. Patients also require physical rest for 24 to 48 hours, avoiding any activity that makes their symptoms

worse: aerobic exercise, weightlifting, and household chores. Treatments that can help include sunglasses for light sensitivity, earplugs or noise-canceling headphones for sound sensitivity. Medicines such as over-the-counter pain relievers and sometimes medicines for sleep or anxiety, can help. There isn’t any specific medicine to treat concussions. After the initial period of rest, patients can slowly transition back to school, exercise and other activities. The patient’s family, caregivers, medical provider and school personnel all need to work together plan a gradual return to activity. Some measures to prevent concussion include the use of protective gear. Helmets and mouth guards reduce overall head and dental injuries, but it’s not clear how much they reduce the risk of concussion. Adhering to the sports safety rules, discouraging excessively aggressive playing styles, and early recognition of symptoms are important. Most states now have laws requiring concussion education for coaches, athletes and their parents. After a possible concussion, athletes should resume play only after cleared by a licensed medical professional. Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.

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

Why Doctors Want School Bells to Ring Later Medical groups recommend that middle and high schools should start 8:30 a.m. or later


ids may be sleeping in to rest up for the upcoming school year, but there are some big questions keeping experts up at night. Is lack of sleep among adolescents paving the way for future health problems? Are school bells ringing too early in the morning? The answer is yes on both counts, according to Marie-Pierre St-Onge, associate professor of nutritional medicine at Columbia University in

New York. She is a leading researcher on the links between sleep and overall health. “Obviously heart disease is not as much of a problem in teenagers,” said St-Onge, who led a panel that wrote a 2016 American Heart Association scientific statement on sleep and heart disease. “But we’re becoming more and more knowledgeable about the adverse health effects of inadequate sleep, and we’re setting them up on a bad trajectory.” In the short run, she said,

Are Your Children Getting Enough Sleep? The consensus is that school children could have a few more hours of sleep By Deborah Jeanne Sergeant


ost parents realize that their children need a good night’s sleep for good health and academic performance, but few children sleep enough. Only one-fifth of children and teens get enough sleep each night, according to a study released in February 2019 by author Gregory Knell, Ph.D., a postdoctoral research fellow at UT Health School of Public Health in Dallas. The National Sleep Foundation’s website states that only 15% of teens sleep enough on school nights. “Studies have shown that children who don’t sleep well won’t perform well,” said physician Zafer Soultan, associate professor of Clinical Pediatrics at Upstate Medical University. “They have problems making decisions, solving problems and coping with changes. They have slower reaction, they make mistakes, and they can feel sad, like they’re depressed. Executive decision-making is affected.” Children and teens who do not get enough sleep at night can have more problems the next day at school. The circadian rhythm shifts for teenagers, making it more difficult to get enough rest. Their internal “clock” urges them to stay up later and awaken later. “Unfortunately, because they’re working, have a lot of homework,

participate in after school activities, or want to go with friends, they alter the circadian rhythm and push it to later times, not 9 or 10, but 12 or 1 a.m. The school districts start very early for high school,” Soultan said. As a result, Soultan adde, many teens are sleep deficient by at least an hour. That can make teens “prone to accidents, eating more, emotional problems and lower grades.” Meghann Peters, registered polysomnography technician with Sleep and Wellness Centers of Western New York, said that lack of sleep can foster behavior that “mimics attention deficit disorder, but it’s not. It’s lack of sleep. It can affect mood and cognitive ability.” Sleep and Wellness Centers operate offices in Auburn, Watertown and Western New York. Peters added that the long-term effects of chronic lack of sleep in children can include obesity, heart disease and diabetes. Peters said that children and teens need more sleep than adults — 10 to 12 hours, compared with 8 for adults — because their growth hormones are released during sleep. Peters recommended several steps for improving sleep: • “Parents need to have children and teens go to bed earlier. They need a set bedtime.

sleep-deprived teens are more prone to risk-taking behaviors ranging from careless driving to drug abuse. They also are losing valuable hours of memory consolidation. That is a process in the brain during sleep that is key to learning. Longer term, St-Onge said, teenagers who sleep in on weekends after an exhausting week develop “what we call a social jet lag. Having a two-hour jet lag has been associated with increased risk of obesity and diabetes. These poor lifestyle habits are being formed in a critical period of development.” A study published last year in the journal Pediatrics echoed that finding. Researchers tracked 829 adolescents and concluded those with longer and better-quality sleep had lower blood pressure, better cholesterol results and less tendency to be overweight. The study concluded it makes sense to assess how improving sleep quantity and quality can be a strategy to improve the “cardiovascular risk profiles” of teenagers. It’s not just that young people like to stay up late. Their circadian rhythms, the internal body clock that determines whether one is sleepy or alert, are changing. “Young children are always up early,” St-Onge said. “But as you get older your circadian rhythms get delayed. It’s a true biological response.” That has led many medical groups, including the American Medical Association, the American Academy of Pediatrics and the American Academy of Sleep Medi• “The parent needs to make sure they set up a controlled environment: a bedroom that’s cool, dark, quiet and comfortable. Turn off the radio. Sleeping to music isn’t helping you. • “Kids should avoid caffeine. Even chocolate has enough to affect sleep. • “Have a set bedtime and don’t deviate from it unless you absolutely have to. • “Especially for younger children, develop a routine like reading for them. Spend 10 to 30 minutes with them before bedtime. • “Do not let your child watch something inappropriate like a scary movie, as that will tend to increase nightmares. • “If the child is still tired and they’re getting 10 to 11 hours of sleep, contact the doctor, as the child may have sleep apnea caused by enlarged tonsils or certain facial features. Soultan suggested: • “Start early on. It’s all a matter of learning. There are very few

September 2019 •

cine, to recommend that middle and high schools should start no earlier than 8:30 a.m. “It’s a complicated public policy problem, but the science is really quite clear,” said Terra Ziporyn Snider, executive director of Start School Later, a nonprofit advocacy group whose name makes its goal clear. “We’re really talking about enforced sleep deprivation across an entire society.” Snider estimates only about 15% of the nearly 14,000 school districts in the U.S. meet the 8:30 a.m. guideline for their high schools. While some districts have changed in recent years, late-start advocates have run into a range of objections: the effects on school bus routes; extracurricular activities; accommodating parent work schedules; and not letting teens sleep in. “People have this old-fashioned reaction. ‘You’re coddling your kids; I did chores at 5 a.m.,’” Snider said. “Community life revolves around school times, and the idea of change gets a lot of people very upset.” sleeping disorders that are out of the hands of the parents. Start good routine habits. Start with a bedtime routine that will help the brain calm down. It can be any routine you want, but it should be very short. For younger children, brushing teeth, shower, and prayers. • “The bedroom is just for sleep only. It’s not for playing or texting. Keep it clean without clutter, and cool. • “Sleep at the same time and wake at the same time, even on weekends. • “They need to try their best to not engage with physical activity close to bedtime, but play sports and do other active things earlier in the day. • “Do not nap, because that shifts your clock. • “Some medication can affect sleep. Anemic children that take iron can have restless leg syndrome. Bipolar or ADHAD can also affect sleep. Severe eczema or asthma can disrupt sleep.”

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his September my little guy will climb on the school bus for the first time and head off into a 13-year-long journey through public education. I’m so excited for him. He’s ready to leave daycare and thrive in a more structured environment. He already knows much of the curriculum he will learn in kindergarten, but he needs the regime and socialization only school can provide. However, as he heads off on his journey, I hear a common refrain from many people I interact with: Have you thought about waiting until he is 6 to start him in kindergarten? You see, my son will be 5 years old this month, but he is small for his age. What he lacks in size, he makes up for in smarts, spunk, determination and charm. I know he is ready for kindergarten, but for many people, this isn’t enough.

Examining a trend There seems to be a growing trend in which parents wait until their boys are 6 to start them in school. There are special cases where this is completely necessary, and I’m not here to debate those cases. However, some people make this decision based on some fear-driven logic. People worry about their sons being mature enough. They want their boys to be strong athletes, so they want to give them a year’s advantage. They don’t want their children being bullied, so they figure an extra year will give them a size and maturity advantage. I’m not here to argue the motives behind these arguments. Parents love their kids so much, and they do what they believe is truly best for them. I don’t think their motives should be questioned; I think their actions should. As much as I think it’s important to protect our children from a sometimes cruel and relentless world, I think it’s equally important to arm them with kindness and strength to temper the societal ugliness they will inevitably encounter.

Reclaiming the power

TOGETHERWEFIGHT hoacny.com Page 16

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

I long for a society where we don’t constantly react to crises. Instead, I want to work toward solutions to prevent bad things from happening in the first place. If I hold my son back a year, I am giving power to a lot of things I don’t agree with — fear of bullying, fear of not being a top athlete, fear of my child not measuring up to his peers. I don’t want fear guiding all of my parenting decisions. Don’t get me wrong, parenting requires a healthy amount of cynicism. I will be on high alert for bullying and other obstacles. As a parent, it’s my job to help him through these things, should he experience them.

However, I think it’s important to take the power back from my personal fears and instead look at what my family can do to address the ugliness that one often associates with growing up. My family needs to focus on what sort of little person we are crafting and help him navigate the real world.

Leading by example Children have the habit of thinking the world revolves around them. It’s likely a survival strategy — a form of self-preservation that’s hard wired. However, somewhere along the way, we have to learn individuals benefit from helping the whole; watching out for number one has to be balanced by watching out for our fellow humans. To move a child out of their sphere of self-centeredness, we have to show kindness and empathy in our daily lives. We have to question our children when they lack empathy. We have to teach them how amazing giving and receiving kindness feels. The only true way to do that is to model kindness and empathy in our daily lives. Let them see the good in us, and they will likely try harder to be good themselves. It’s equally important to stand strong against the wrongs we see in our lives. As adults, when we see someone being bullied, it’s our job to call attention to it and defend the victim. When we see someone being mean to another person, we can’t be complicit to protect our own position, even if it makes us unpopular among our peers. We can’t be mean to others, especially in front of kids. We need to treat people with respect, regardless of our perceived stature. Our kids are watching; don’t doubt it for a second.

Arming them for kindergarten My son will tackle the first couple of weeks of kindergarten while he is still 4. When I help him onto the school bus, he will be carrying a lot of stuff. He will carry a backpack that is several sizes too large for him. In that backpack, there will likely be a favorite stuffed animal and a dinosaur figurine. In his heart, he will carry something that is just the right size for him, the strength to make kindergarten a kinder place.

Back to School on the Autism Spectrum A new academic year is always a challenge for some on the autism spectrum. But parents can take some steps to reduce the problem By Deborah Jeanne Sergeant


or some children on the autism spectrum, the change from summertime to school time represents a challenging ordeal. In general, children on the autism spectrum tend to rely upon predictability to feel more comfortable. New teachers, classmates, classrooms, books and more — all at once — can cause a good deal of distress for some. Will Sullivan, Ph.D., assistant professor and licensed psychologist in pediatrics at Upstate Medical University, advises parents of children on the spectrum to plan ahead for a smoother transition as they head back to school. “The first thing that parents should do is prepare their child for the upcoming transition back to school by making it as predictable as possible,” Sullivan said. This could include getting to bed and rising in the morning at the same times as if school were in session, which can be helpful, so once school does start, they’re already on the right schedule — and well rested. “It may also help mark a countdown on a calendar until school starts so children understand what’s happening,” Sullivan said. “They can better visualize the upcoming school year as they mark off one day closer

7 T

rides. Meeting new school personnel in advance or obtaining photos of them is also positive. It may also ease the adjustment to avoid planning anything in the evening for the first few weeks of school so children can get more rest. Springing surprises on children — especially at an already stressful event such as going back to school — can only ramp up their anxiety even more. Especially for children beginning school or attending a new school, it may help to practice at home. “Get your child used to the sorts of activities and expectations that will be placed on them at school,” Sullivan said. “For example, roleplay with your child about what they will experience in the school setting so that the child is prepared and knows what to expect.” It’s also helpful to ensure adults populating the school day know the needs of the children on the autism spectrum. Leah Phaneuf, part of the clinical programs at The Kelberman Center located in Syracuse, advises putting together a sheet of pertinent informa-

Myths About Children’s Eyes

The American Academy of Ophthalmology reveals seven common misunderstandings about children’s eye health

hink you have the facts on your child’s eye care? When is the right time to have their eyes checked? Is too much screen time damaging their eyes? Do they need to wear sunglasses? There are a lot of myths and misinformation out there about children’s eye health. Don’t turn to Dr. Google for answers, ask your ophthalmologist — a physician who specializes in medical and surgical eye care — if you want to set your child up for a lifetime of good vision. Here, the American Academy of Ophthalmology debunks seven common myths about children’s eye health:


to school.” He added that talking about going back to school and reviewing transitions with a visual schedule can help them know what’s to come. Children could practice reading and writing at a desk, eating from a lunchbox or other activities they will do at school. Parents may also want to talk with their children about what-if scenarios, such as what they would do in case of a fire drill, a missed bus or a forgotten lunchbox. Buying all the school supplies and clothing well in advance can take the pressure off the week of school. Plus, children will be able to become more accustomed to their new things before school starts. A few times before school begins, it may help to take a tour of the building, walking around to the classrooms, lunchroom and bus pickup and drop-off points. “Introduce your child to the teacher and bus driver,” Sullivan said. “Ensure that your child’s school team has a clear plan in place for your child the moment they step foot back into the school building.” Recording the tour can help familiarize children before the first day. Make note of their bus number can help ensure they don’t miss their

Pink eye only happens in young children. While young kids are known for getting pink eye, due to close contact in day care centers, so can teenagers, college students, and adults — especially those who don’t clean their contacts. The best way to keep pink eye from spreading is to practice good hygiene, including washing your hands, not touching your eyes, and using clean towels and other products around the face.


Antibiotics are necessary to cure your child’s pink eye. Antibiotics are rarely necessary to treat pink eye. There are three types of pink eye: viral, bacterial and allergic conjunctivitis. Most cases are caused by viral infections or allergies and do not respond to antibiotics. Antibiotics may be prescribed for bacterial conjunctivitis depending on severity. Mild cases of bacterial conjunctivitis usually resolve on their own within 7 to 14 days without treatment.

Sun is bad for your eyes. While it’s 3. true that long-term exposure to the sun without proper protec-

tion can increase the risk of eye disease, some studies suggest sun exposure is necessary for normal visual development. Children who have less sun exposure seem to be at higher risk for developing myopia or nearsightedness. Just make sure they’re protected with UV-blocking sunglasses and sunscreen.


Blue light from screens is damaging children’s vision. Contrary to what you may be reading on the Internet,

blue light is not blinding you or your screen-obsessed kids. While it is true that nearsightedness is becoming more common, blue light isn’t the culprit. In fact, we are exposed to much more blue light naturally from the sun than we are from our screens. The important thing to remember is to take frequent breaks. The Academy recommends a 20-20-20 rule: look at an object at least 20 feet away every 20 minutes for at least 20 seconds. Vision loss only happens to adults. 5. The eyes of a child with amblyopia (lazy eye) may look normal,

but this eye condition can steal sight if not treated. Amblyopia is when vision in one of the child’s eyes is reduced because the eye and brain are not working together properly. Strabismus (crossed eyes) is another eye condition that can cause vision loss in a child. Strabismus is when the eyes do not line up in the same direction when focusing on an object.

All farsighted children need glass6. es. Most children are farsighted early in life. It’s actually normal. It

tion on the child. “Even if this information is already included on an IEP [individualized educational plan], it is helpful for teachers to have a ‘cheat sheet’ summarizing interests and needs,” Phaneuf said. She added that the sheet could include favorite foods, activities, toys or other items; mealtime and toileting procedures; supportive behavior systems; communication abilities and needs; allergies; and “any additional information that would help others understand how best to support your child.” Ideally, parents should provide the information sheet to teachers and providers through email before school starts and send a copy along for the first day of school. She also thinks that using checklists, calendars and role playing the regular activities of school can help. Parental response to the back-toschool period also matters, so if parents worry about what their children will face, their children can pick up on that anxiety. Remaining calm can help foster a sense of calm in their children. needs glasses because they use their focusing muscles to provide clear vision for both distance and near vision. Children do need glasses when their farsightedness blurs their vision or leads to strabismus. They will also need glasses if they are significantly more farsighted in one eye compared with the other, a condition that puts them at risk of developing amblyopia. There is no difference between 7. a vision screening and a vision exam. While it’s true that your child’s

eyes should be checked regularly, a less invasive vision screening by a pediatrician, family doctor, ophthalmologist, optometrist, orthoptist or person trained in vision assessment of preschool children, is adequate for most children. If the screening detects a problem, the child may need to see an ophthalmologist or other eye care professional. A comprehensive exam involves the use of eye drops to dilate the pupil, enabling a more thorough investigation of the overall health of the eye and visual system. “As the kids head back to school, show them that you’ve done your homework,” said physician Dianna Seldomridge, clinical spokesperson for the American Academy of Ophthalmology. “Educate yourself so they will have the best chance to preserve their vision for a lifetime.”

doesn’t necessarily mean your child

September 2019 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 17

Asthma, Allergies: New School Year Can Bring Flare-Ups A

s kids head back to school, it’s important for parents to keep potential asthma and allergy challenges in mind. “In the fall, allergists see an increase in kids’ visits for allergies and asthma because of a combination of factors,” said physician Todd Mahr, president of the American College of Allergy, Asthma and Immunology (ACAAI). “And hospitals see what’s known as the ‘September spike’ because kids who have been off asthma controller medications for the summer start experiencing flare-ups in the fall.” As a new school year begins, kids are exposed to allergens in the classroom, on playing fields and in

the cafeteria that many probably haven’t run into all summer, he said in an ACAAI news release. On top of that, it’s ragweed season — a terrible time of year for kids who are allergic. Mahr suggests parents meet with their child’s allergist this month to create an allergy action plan. Parents should also try to identify potential asthma and allergy triggers that their children may encounter at school. These may include chemical compounds from new carpeting, pollen drifting into classrooms through open windows, or mold in bathrooms. Parents should discuss potential triggers with teachers and school administrators to help ease symptoms.

Children with asthma or allergies should still be able to play any sport as long as they follow their allergist’s advice, according to the ACAAI. While physical activity can cause airways to constrict, if your child’s asthma is under control, he or she should be able to participate. Make sure coaches and physical education teachers know what to do if a problem arises. If your child has a food allergy, make sure the school is fully informed. Work with your allergist and school staff to develop an action

plan that lists foods your child is allergic to, treatment procedures and emergency contact information, the ACAAI advised. Be sure your child understands what to do if he or she suffers an allergy or asthma emergency at school. They should carry and know how to use asthma and anaphylaxis medications, and school staff also should know how to administer them.

Sensory Clothing Meets Kids’ Needs

Sensory issues are common among people on the autism spectrum By Deborah Jeanne Sergeant


or many families, shopping for back-to-school clothes is more than another errand. It’s a big challenge because their children’s sensory issues make ordinary garments extremely uncomfortable — even painful — to wear. A tickly tag or garment’s seam easily ignored by other children feels very bothersome to a child with sensory differences. Stiff fabric, bumpy textures and hard garment features like zippers, grommets and buttons rule out many garments, as these cause non-stop irritation. Sensory issues are common among people on the autism spectrum. “Many children with autism spectrum disorder have unique sensory needs,” said Will Sullivan, Ph.D., assistant professor and licensed psychologist in pediatrics at Upstate Medical University. “However, these needs are not the same for all children. Therefore, there is not a one-size-fits-all approach. Parents should seek a sensory evaluation by an occupational therapist to better understand their child’s unique needs. “ Some who are not on the autism spectrum also live with sensory issues. Joyce Wagner, Ph.D., of Restoration Counseling of Rochester provides supervisory services at Mary Cariola Children’s Center, a school for children on the autism spectrum and with learning challenges in Rochester. Paraphrasing autism expert Temple Grandin, Wagner said that people not on the autism spectrum have 10 “cables” wired to their brain, with two going to each of the senses. In autistic children, “some are re-wired,” Wagner said. “They may have four or five going to the sense of touch. It is like a typical person wearing a scratchy wool sweater against the skin. If you can’t get comfortable Page 18

you can’t calm down. Their skin is super sensitive.” It’s not a simple preference for soft clothing, which neuro-typical people experience. It’s a necessity to feel comfortable and relaxed. Children with sensory disorders may have different clothing needs and aversions. For 14-year-old Ian Latten of Rochester, silk screen decals on T-shirts are among the clothing features that he cannot tolerate. His mom is Lisa M. Latten, health project coordinator of the Southern Tier Initiative at University of Rochester Medical Center Division of Developmental and Behavioral Pediatrics. Latten has noticed that as Ian has grown older, it’s been more challenging to find comfortable fabrics and fits for him. A ninth-grader this year, Ian likes shirts with no tags or embellishments and socks without seams inside. “He has to look at everything and make sure there’s no tag,” Latten said. “If the tag is on the side, he wants the tag cut off. He feels it and knows to look for it.” Many mainstream manufacturers have opted for printed tags instead of physical tags, which has made finding shirts a little easier. Finding pants Ian likes is more difficult. Latten feels thankful for the current athletic wear/leisure wear trend that favors slip-on pants in soft fabrics, since Ian cannot wear jeans, corduroy or khaki fabrics or pants that zip and button. She said that some parents of children on the autism spectrum relate that their children experience similar issues. Some have limited fine motor skills, so clothing with hidden Velcro fasteners and shoes that slip on and off make dressing easier. While children with sensory issues usually let their parents know what irritates them, the problem lies in finding clothing that accommo-

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

dates their children’s needs, looks like their friends’ clothing, and fits within the family budget. “Having other parents within the autism community to ask about what worked for their child is really important,” Latten said. “Parents who have done this before you know all the tricks.” While specialty stores and websites sell sensory sensitive clothing, the colors and styles are usually very limited and not stylish. Older children may not want to wear something different from their friends. Since “feeling is believing” for many children like Ian, shopping at retailers in-person may spare a family a huge pile of returns to ship back. Clothing from specialty stores also tend to cost more than clothing from mainstream stores in many cases. “It’s about finding what works,” Latten said. She noted that a few stores are beginning to stock sensory clothing as they become more aware and accepting of children’s needs and realize that sensory clothing isn’t a trend but a previously unfilled need for some families. Trying out new clothing and accessories at home can help families learn what will work before having the children wear them to school for the first time. Leah Phaneuf, part of the clinical programs at The Kelberman Center located in Syracuse, advises parents to use this strategy. “If your child has never carried a backpack or is not comfortable with wearing school clothes, it would be a good idea to begin practicing these skills before the first day of school,” Phaneeuf said. “You can practice carrying a backpack and/or tolerating new clothing in small increments of times, rewarding progressive successes.”

Where to Find Sensory Clothing

So where can parents find sensory friendly clothing in mainstream stores? • Target offers numerous sensory friendly selections among their Cat & Jack line. • Kohl’s Jumping Beans, SO and Urban Pipeline clothing also provide sensory conscious features. • Tommy Hilfiger’s Adaptive line includes clothing with features such as magnetic closures for people with fine motor difficulties, pre-washed softness and printed tags. • Many shirts at Old Navy and Under Armor feature printed tags, no silk screens or appliqués and soft fabrics. The latter also carries compression clothing. Though intended for athletes, these tight garments in moisture-wicking fabrics appeal to those who feel soothed by snug clothing. • Zappos sells many lines of clothing and shoes that meet a variety of needs, such as clothing that can be worn inside out or backwards (Independence Day, 4Ward), zipper-opening shoes (Billy Footwear, Nike), and easy-closure garments (MagnaReady). Stores that specifically target sensory needs include: • www.kozieclothes.com (sensory clothing, including compression) • www.funandfunction.com (sensory clothing, including compression) • www.worldssoftest.com (soft socks) • www.nonetz.com (swim trunks with no net liner)

grumpy.” She recommends that parents get their children involved in menu planning and food preparation so that they feel more enthusiastic about eating breakfast. “Make it fun and be creative in presentation such as cookie cutters to cut toast, use dips such as vanilla with fruit or hummus or peanut butter with vegetables,” Mellen said. “Healthy breakfast should include a whole grain carbohydrate, preferably with fiber, protein rich food, a fruit or vegetable and some healthful fat,” Mellen said. She added that carbohydrates provide energy, protein fosters a feeling of satiety while stabilizing blood sugar and supporting muscle growth and fat provides energy and aids in absorption of fat soluble vitamins. “Hard boiled eggs, cottage cheese, cheese sticks, trail mix fruit, nut butters are all good things to keep on hand,” Mellen added. Mixing and matching these foods can provide something new for children who easily become bored with breakfast. If you lack time to prepare much on busy school mornings, you have options. Laurel Sterling, registered dietitian, nutritionist and educator for Carlson Laboratories, said that a breakfast rich in fiber, protein, good fats and iron “start the day off great for kids which support healthy moods, focus, learning, and testing.” To do so on a time crunch, she suggested: • Greek yogurt with berries • chia pudding with nuts and berries • smoothie with almond butter,

Healthful Breakfast Important for School Performance By Deborah Jeanne Sergeant


necdotally, breakfast is the most important meal of the day. But the old saying holds some merit, especially to children and teens headed back to school. “I have always encouraged my kids at home and in practice to eat a healthful breakfast for a variety of reasons,” said Juliann Mellen, registered dietitian and certified diabetes educator at Upstate Medical University. “It is a nice way to start off the day and creates an opportunity for communication before the day gets started. There is quite a bit of research that says eating breakfast

helps with memory, concentration and productivity, which supports doing better at school. What children eat is just as important, since a breakfast of simple carbohydrates such as a white flour bagel, sugary breakfast cereal, cereal bar, toaster pastry or white toast won’t stick with them. “Eating a healthful breakfast can help with weight management and weight loss,” Mellen said. “If you skip breakfast you may overeat later on in the day. Eating breakfast can help regulate blood sugar making you feel better, healthier and less

oats, Greek yogurt, fruits and greens • steel cut oats, with fruit and walnuts • egg muffin (see sidebar) • homemade breakfast bars with nuts, seeds, oats, etc Try preparing food in advance, like baking egg muffins to supply the entire week. Or check your slow cooker’s recipe booklet or online for overnight hot cereal options.

Egg Muffins - Serves 12 1 dozen eggs salt, pepper assorted vegetables Beat eggs and add salt and pepper to preference. Pour into a well-greased, 12-muffin standard sized tin. Add minced raw vegetables like red and green peppers, onions, mushrooms and spinach and shredded cheese. Bake 15 to 18 minutes in a pre-heated 350 degree oven. These may be stored for a few days in the refrigerator and reheated in the microwave for 20 seconds to serve.

Looks Like Guys Are More Prone to Pack on the ‘Freshman 15’


hen a high school senior becomes a university freshman, change is the name of the game. A new school. New friendships. Even new ways of eating. As healthy, home-cooked meals give way to a campus diet of beer and pizza, student waistlines tend to expand. But new research shows it is the waistlines of boys that expand the most. “Males and females display different patterns of body weight and body composition changes during first-year university,” explained study author Andrea Josse.

year students (229 females and 72 males), aged 17 to 20, who completed the freshman diet survey. Nearly three-quarters lived in a campus residence, while roughly one-quarter lived at home. Two polls were conducted — one How different? Poll results on more lean body mass than girls between 2014 and 2015, and one berevealed that girls gained an averduring their first year at college, in tween 2015 and 2016. Each poll was age of about 4 pounds during their the end they were more likely to end administered at the start of the first first year at university, said Josse, an up becoming overweight than girls, year and again towards the end. assistant professor in the School of the researchers found. All participants underwent body Kinesiology and Health Sciences at Why? Josse pointed to changing composition testing to assess overall York University in Toronto. alcohol habits as a possible culprit, body weight, body fat percentage But among the male first-year noting that while drinking went up and lean body mass. students, weight gains roughly douacross the spectrum, it went up more The investigators found that total bled that, hitting an average of about among boys. caloric intake did not change much 8 pounds, she said. Male students “displayed greater over the course of the students’ first Freshman boys also saw bigger reductions in vegetable intake and year at school. increases in terms of waist size and greater increases in doughnuts/ However, food quality did 4/25/2019 Copy of tara ad - Google Docs overall fat mass than girls, Josse cakes, fried chicken, beer and liquor, decline, while alcohol consumption added. compared to females,” said Josse. increased, particularly among boys. And while boys also packed The study included 301 first-


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Excessive Video Game Playing Now Considered a Disorder By Deborah Jeanne Sergeant


he World Health Organization in May classified excessive video gaming as a disorder, and the American Psychiatric Association has included “internet gaming disorder” as a diagnosis. “The keys to seeing it as a disorder are the impairments in functioning as a result of excessive video game use,” said physician Christopher P. Lucas, associated professor of psychiatry and behavioral sciences at Upstate Medical University. “These could be loss of sleep, inability to get schoolwork done, loss of other day-to-day activities or repetitive use injuries to thumbs. “The other elements that would make this like an ‘addiction’ would be increased use over time, acute distress when prevented from using the video game and continued use despite negative consequences,” Lucas said. As ubiquitous as video games

have become, it’s little wonder. Games are available on phones, tablets, laptops and game consoles. “The latest research shows people in three quarters of US homes play video games in some capacity,” said Scott Mooney, Ph.D., co-founder of Beacon Psychological Services, PLLC in Oswego. “The American Academy of Pediatrics published a study that found basically of the youth who are part of the study, a significant number of people play video games at an ‘addictive’ level. Twenty hours a week for children was average. About 10% had signs of video game addictive behavior. On top of that, 4 to 5% showed a more serious problem with 50-plus hours,” Mooney said. What is so captivating about excessive gaming that players can, essentially, become dependent on it? Isn’t it just another fun pastime for children and teens?

Mooney said that gaming possesses addictive quality that other hobbies don’t. “People aren’t addicted as much to games that aren’t as high energy and exciting,” he said. “Pong was not wildly stimulating. There’s much more stimulation in today’s games that are more attention focused.” Bright, realistic graphics, sound effects, music and customizable and interactive characters have made games much more engaging. Games are also easily accessible. While children 35 years ago had to haul quarters to the mall’s arcade or visit their one friend lucky enough to own a home game system, today’s children have 24/7 access on laptops, tablets and phones. The gaming world also allows users to connect with others with similar interests in real time as they vicariously live in imaginary worlds as a break from the mundane real world and a self image they may not like. Games offer instant gratification. Some gamers may feel frustrated by their inability to succeed in their daily lives; however, while playing games they can save the day, win the race or beat the bad guys. These “accomplishments” release dopamine into the brain. “They feel good and that’s why they play,” Mooney said. “The more extreme users tend to be depressed, disenfranchised and they retreat into the video gaming world. They may feel more successful playing the game than those around them.” But spending too much time gaming and talking about gaming constantly can indicate a problem. The pleasure center craves more and more stimuli to remain satisfied. When this phenomenon occurs, many gamers lose awareness of what they’re doing or the passing of time. And that “zoned out” feeling enhances the experience for gamers who want to escape their lives. They become dependent upon gaming as a coping mechanism. Obsessive video gaming looks on many levels like addictive behavior. “These are kids typically unhappy with their lives and disengaged from others,” Mooney said. “That’s what we work on in terms of treat-

ments. We get a proper diagnosis if there is depression. We try to resolve issues so they don’t feel they need to rely on video games.” For some gamers, the chat rooms associated with games provide their main social connection. Though their chat “buddies” are strangers, they feel close to them because of their shared interest of gaming, which provides a shortcut to acquaintance. Breaking away from that to form in-person, deeper and often more challenging relationships is difficult for children and teens who have stunted their interpersonal skills by excessive gaming. “Depending on the child’s age, there may be markedly different ways to respond,” Mooney said. “Try talking with them. A parent can say, ‘I like the fact that you like playing games but my concern is the time you spend playing is taking away from family time. You used to play soccer and now you just want to play games.’” Children and teens who have played longer will be more likely to resist cutting back on their gaming time. Rita Worlock, licensed clinical social worker and owner of Insight to Therapy Mental Health and Wellness Center in Syracuse, said that parents may need to have their children evaluated for mental health issues to address what else is going on. Then, parents can begin to curtail their children’s game time. “Keep phones and other gadgets out of the bedroom,” Worlock said. “Introduce your kids to other things to do. I ask parents, ‘What are your children getting involved in?’ Give them something to do or they’ll be bored and start playing games.” Spending free time playing outdoors, getting involved in teams and activities and engaging in hobbies are all healthy ways to reduce gaming time. But parents should not expect children to drop gaming cold turkey. “I don’t believe in cutting out all usage of it,” Worlock said. “Some can’t cut themselves right off. They may need to be eased off. I can’t tell you the kids and adults I see who are addicted to gaming. It’s a secret addiction. We don’t take it that seriously and we should.”

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Type 2 Diabetes Reversible? Once someone has been diagnosed with Type 2 diabetes, can lifestyle changes in diet and exercise reverse it — even cure it? By Deborah Jeanne Sergeant


ype 2 diabetes affects nearly one 2 diabetes, it can reduce dependence in 10 Americans, according to upon medication and the risk of comthe Centers for Disease Control plications that can accompany Type and Prevention (CDC). Although 2 diabetes, including heart disease, most people who have Type 2 diabevision loss, and kidney disease. tes are over age 45, the CDC further “The majority of people with states that diabetes is on the rise Type 2 diabetes are overweight or among younger people. obese, and physical inactivity is comPhysician Ruth Weinstock, distin- mon,” Weinstock said. “Weight loss guished service professor of mediand increased physical activity are cine and medical director of Upstate helpful, reducing insulin resistance. Medical University’s Joslin Diabetes For some patients who have not had Center, explained how diabetes diabetes for a very long period of works. time, lifestyle change with weight “Type 2 diabetes represents a het- loss can normalize blood glucose erogeneous groups of diseases, all of levels.” which are characterized by elevated The damage to the pancreas varblood sugar — glucose — levels,” she ies among diabetics. Weinstock said said. “The pancreas does not make that the more severely the person is enough insulin, the hormone needed insulin deficient, the less likely diet to keep blood glucose readings norand exercise alone can normalize mal, and the body is resistant to the blood glucose levels. action of insulin.” “The duration of the diabetes, Because of this damage to the the need for insulin therapy, genetics, pancreas, people with Type 2 diabeas well as other factors determine tes require more insulin to maintain whether Type 2 diabetes in a particnormal, healthy blood sugar levels ular person can be ‘reversed’ with and other hormone levels. diet and lifestyle change,” Weinstock Once someone has been diagsaid. “But adapting a healthy lifenosed with Type 2 diabetes, can style is of benefit for all people with lifestyle changes in diet and exercise diabetes. “ reverse it, even cure it? Since the damage to the pancreas The experts say no, but lifestyle can’t be undone, medical providers changes can prevent Type 2 diabetes don’t use the word “cure.” However, 18.XXX_Urology_MeetTheTeam_Horiz.qxp_Layout 1 11/14/18 9:28 AM 1 and, for those diagnosed with Type lifestyle changes canPage reduce need

for medication and help lower risk or delay onset of diabetes complications. Reverting to their previous diet and sedentary lifestyle will undo any progress they’ve made. “A healthy lifestyle is very important,” Weinstock said. “Meal planning should be individualized, taking into account the food preferences of the family, dietary needs dictated by other co-existing medical conditions, and any financial or other constraints. Sustainability is of the utmost importance. I do not recommend crash diets.” She said that reducing sodium and alcohol intake is important, as well as carbohydrates. “They are the major dietary source of glucose, and should not be consumed in excess,” Weinstock said. “In general, complex carbohydrates are preferred over simple carbohydrates.” Complex carbohydrates are found in foods like oatmeal, popcorn, brown rice and whole grain pasta and whole grain bread. Simple carbohydrates examples include white bread, white rice, white potatoes, standard pasta, and desserts like cake, cookies and pastries. Instead of the latter, Laurel Sterling, registered dietitian, nutritionist and educator with Carlson Laboratories in Canastota, advises that people with Type 2 diabetes should eat “ample protein and fiber-rich veggies with each meal and lower amounts of overall carbohydrates, especially simple carbohydrates with higher sugar content,” she said. Skipping meals is also a no-no. Instead, Sterling said they should eat

three meals a day and, if needed to keep blood sugar stable, have small, protein- and fiber-rich snacks between meals. “Adding in a daily exercise routine will assist better levels of blood sugar by using up extra glucose that is in the bloodstream, and losing at least 10% body weight significantly aids levels as well. Certain supplements can support blood sugar levels as well.” Exercise can also aid in weight loss. Weinstock encourages diabetics who are overweight to “achieve and maintain a normal body weight when possible. Physical activity is also important. In general, for adults, 150 minutes or more of aerobic activity each week is recommended.” For people who have not recently exercised, gradual introduction under the guidance of their healthcare provider is important to avoid injury. “Exercise should be customized to the individual,” Weinstock said. “Everyone should be counseled to stop smoking.” Diabetics should discuss reducing medication with their healthcare providers before making any changes.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 21

Career: Diagnostic Medical Sonography Career requires only an associate’s degree. It pays about $72K in Syracuse By Deborah Jeanne Sergeant


ould you like a career in a medical field that requires an associate’s degree but starts at around a $72,000 salary in the Syracuse area? Consider becoming a diagnostic medical sonographer — or a technician who takes ultrasound images for physicians. In addition to a healthy return on investment, the career offers a job outlook of 17 percent growth from 2016 to 2026, considered “much faster” than other jobs by the Bureau of Labor Statistics. Kenneth Galbraith, program director of Diagnostic Medical Sonography at SUNY Upstate Medical University, graduated from the College of Health Professional Medical Imaging Sciences. As he rotated through imaging, he had the opportunity to rotate through sonography. “I thought it was an interesting offshoot of radiography,” Galbraith said. “It was a little more artsy than the others in that it’s a free form modality that made it more appealing to me.” He completed coursework in sonography, practiced 17 years, and now he teaches all the professional courses, handles clinical coordination and runs the ultrasound lab. Many people stereotypically picture the sonographer as the person who takes ultrasounds of their baby before birth; however, the career has many other options, too. Sonographers work in hospitals, doctor’s offices, and non-medical boutiques that offer sonography sessions for families to “meet” their new baby before birth (although this sub-specialty isn’t diagnostic in nature). Typical OB-GYN offices don’t

have much room for the entire family to join the first glimpse of the baby. That’s the reason behind the non-diagnostic ultrasound offered at offices. The medical specialties include vascular, ophthalmology, cardiac, pediatric and many more. In addition to practicing, related opportunities could include managing, education and working for companies that build and sell the equipment. Galbraith believes that people skills are necessary for sonographers. “Sometimes, you see people who are not on their best behavior,” he said. “They’re hurt or scared. They’ve had to drive to a place they’re not familiar with. You need to be intellectually curious and want to always get better.” He likens ultrasound to learning to play a musical instrument. With practice, sonographers improve their skill. A strong aptitude in science helps with the technical aspects, as anatomy, physiology, and physics are integral. Sonographers take continuing education credits to keep their credential and stay up-to-date. In New York, only an associate’s degree is required before sitting for the required certification exam. The national credential is also widely recognized worldwide. “Employability is very good,” Galbraith said. All of his graduates have found employment within two months. “I love the idea that you can feel you can make a difference for someone,” Galbraith said. “Some people go into a hospital or exam and they’re scared. We don’t stick needles in. Most people in OB-GNY

are excited to come in. We spend time with them, talk with them and make their day better. We have this great opportunity because we’re so handson. You give them a good feeling.” Valerie Heisler, sonographer with Syracuse VA Medical Center, specializes in general and vascular sonography. She had worked as an X-ray technician, but when a supervisory position opened, she needed cross training in sonography to quality for it. When she began on-the-job training, she discovered she enjoyed sonography. “I have a knack for it,” she said. “It’s like patting your head and rubbing your stomach. It takes eye-hand coordination.” With her imaging background, on-the-job training sufficed. Though the state of New York doesn’t require certification for sonographers, it is usually expected by employers, especially for people without experience in imaging.

“It’s a very interesting career if you like hands-on, which is one of the reasons I like it,” Heisler said. “You’re in close contact with patients, you converse with them and hear their stories.” While she likes these aspects of her work, she said that it has its challenges as well. The ultrasound probes must be applied to the pertinent area of the body with sufficient force to render a useable image. This can cause repetitive motion injuries in the shoulders. “We have to put a lot of strength and compression into it,” Heisler said. “The population is getting obese, and ultrasound can only go to a certain depth. You get under-quality images and can get injuries. You have to press harder. One patient apologized and said he lost 10 pounds since I last saw him. He feels the pressure.”

Safe Ways to Get Rid of Expired, Unused Medicine By Jim Miller


leaning out the medicine cabinet is a chore that most people don’t think about, but it’s an important task that can help prevent medication problems, and protect children who may have access to these old, unused drugs. Here’s how you can clean out your mother’s medicine cabinet so it’s safe and useful.

Return Them

Your local pharmacy, as well as hospitals, clinics, long-term-care facilities and narcotic treatment programs might accept your unused medications, often as part of programs that collect and destroy unused drugs. Search for an authorized facility near you at DisposeMyMeds. org. You can also drop off her unused meds at designated police departments, fire stations and other sites on certain dates. To find a collection site near you, visit TakeBackDay.dea.gov.

Use a Disposal Kiosk

Many Walgreens and CVS stores Page 22

have free, anonymous and secure kiosks where you can dispose of any medication. Remove your personal information from the packaging and drop unwanted medication, including opioids, in the slot.

Mail Them

Costco, Rite Aid and CVS pharmacies sell postage-paid envelopes for customers to mail any prescription, including opioids and over-thecounter medications, to a disposal facility.

Throw Them Out

If mailing them in or getting to one of the drop-off sites is not an option, you can dispose of them yourself, but do so carefully. The Food and Drug Administration recommends taking the medications out of their original bottles and putting them in a sealable plastic bag with an undesirable substance like coffee grounds, dirt or kitty litter. Then seal the plastic bag and throw it in the trash. This will make the medication less appealing to children, pets or

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

other people who may fish through your trash. But don’t do this with dangerous drugs, such as opioids, which can be abused. For these, the FDA says flushing them down the toilet is OK. But trace amounts of drugs can end up in the water supply so this should be done only as a last resort. To see the FDA list of medications that should be flushed when they are no longer needed, go to FDA.gov and type “flush list” into the search box. Or, another option is to purchase some medication disposal bags like the Medsaway Medication Disposal System. These are carbon pouches that are designed to neutralize all medication including narcotics, liquid medication, transdermal patches and controlled substances so you can just add water, and toss them in the trash. You can find medication disposal bags at some local pharmacies or online at Amazon.com for around $15. You’ll also want to make sure to scratch out all your mom’s personal information on the empty medicine bottles or other packaging before

throwing it away to protect her identity and privacy. If you have other questions about proper drug disposal, talk to your pharmacist.

Health Tip: Preventing Falls Among Older Adults

Every 11 seconds, an elderly person is taken to the hospital for a fall-related injury, says the U.S. National Council on Aging. Though the number is staggering, most falls are preventable, the council says. The council encourages elderly people to: • Find a balance and exercise program. • Speak with a health care provider. • Regularly review your medications and note side effects. • Get your vision and hearing checked annually. • Keep your home safe. • Enlist the support of family members.

New Hospital Ranking Puts St. Joseph’s as No. 1 in CNY By Payne Horning


t. Joseph’s Health Hospital in Syracuse has been named the best hospital in Central New York. More than 4,500 community hospitals in the country were evaluated for the annual U.S. News & World Report ranking. St. Joseph’s came in at No. 19 in New York, higher than any in the region but behind hospitals in New York City, Albany, Rochester and Buffalo. Crouse Hospital in Syracuse, Arnot Ogden Medical Center in Elmira and St. Elizabeth Medical Center in Utica all tied for No. 25 within the state. “We’re really happy about it,” said Leslie Luke, St. Joseph’s president CEO. “I think that a lot of our colleagues look at things like this mainly as the indicator of how they’re performing. So when we receive recognition like that, it’s an affirmation of the quality of work

that they’re doing.” Four main criteria were measured to develop the list. Patient outcomes like survival rates, patient experiences, expert opinions, and other care-related indicators like nurse staffing and patient volume all factored into a hospital’s final score. St. Joseph’s received a cumulative three out of five stars for patient experience and was recognized as “high performing” in eight procedures and conditions: abdominal aortic aneurysm repair, aortic valve surgery, chronic obstructive pulmonary disease (COPD), colon cancer surgery, heart bypass surgery, heart failure, hip replacement and knee replacement. It’s the fifth consecutive time that St. Joseph’s has been ranked atop its field in Central New York. Luke says coming in at No. 1 is a little more pleasant this year since the hospital is celebrating its 150th anniversary in

Grant to Encourage Nursing Students to Work in Rural Areas


pstate Medical University’s College of Nursing has received a four-year, $2.7 million grant to support students who are interested in working in rural or underserved areas after graduation. The Advanced Nursing Education Workforce (ANEW) grant, from the Health Resources and Services Administration through the U.S. Department of Health and Human Services, is about $670,000 per year and will provide scholarships to the equivalent of 16 full-time family nurse practitioner students. (The annual number of students could exceed 16 as some scholarships may be awarded to part-time students.) The $22,000 scholarships — pro-rated for part-time — can pay for tuition,

books or living expenses. Students will be eligible to apply for the scholarship during their last year of nursing studies at Upstate’s College of Nursing. This student stipend will allow students to reduce the number of hours they need to work and focus additional time on their studies, said College of Nursing Assistant Professor Sherri McMullen, who worked with a team from the College of Nursing to write the grant. “This grant was looking for an academic center to partner with community organizations to provide access to primary care in rural and underserved areas,” McMullen said. “The College of Nursing is partnering with Upstate University Hospital and ConnextCare in Oswego Coun-

2019. Despite remaining in first place in the region, St. Joseph’s fell in the rankings statewide. In last year’s U.S. News & World Report list, St. Joseph’s was No. 10 in New York. Luke says officials are still looking into the reason behind the nine-place drop but notes that the methodology changed this year. U.S. News & World Report says it revised its formula to incorporate more patient satisfaction measures, to account for differences in-patient populations, and to address feedback from healthcare professionals. For these reasons, it recommends not comparing a hospital’s performance in the 2019 rankings to previous years. Still, one potential explanation for St. Joseph’s fall to No. 19 could be related to how the hospital’s staff communicates with patients. Some of its lowest scores were for satisfacty.”

According to the HRSA grant description: “The ANEW program supports academic clinical partnerships to educate and graduate primary care nurse practitioners (NP), clinical nurse specialists (CNS) and nurse midwives (NM) who are academically and clinically prepared for the unique challenges of transitioning from nursing school to practice in rural and underserved communities, thereby increasing access to needed primary medical care for these populations.” The grant will support training for preceptors, instructors and faculty working with the ANEW FNP students. McMullen said she and others are working on the curriculum now, which will also include cultural competency training, to provide students with additional education on how the culture of rural or underserved areas can affect people and their health. “Rural and underserved areas September 2019 •

tion with how nurses and doctors communicated, specifically with how well patients were informed about how to take medication and any potential side effects related to it. “I think that goes to how we’re communicating information because we’re definitely communicating it, but obviously we may not be communicating it in a way that’s easy to understand by the patient or his or her family,” Luke said. “When you’re in the hospital not feeling particularly good, a conversation can occur and you’re just not in the state of mind to really understand it. So, we have to be more sensitive to that and figure out a way to more concisely and clearly communicate those kinds of things to our patients.” Elsewhere in Central New York, Arnot Ogden Medical Center in Elmira received three out of five stars for patient experience and was recognized as “high performing” for chronic obstructive pulmonary disease (COPD), heart failure and knee replacement. Crouse Hospital received two out of five stars for patient experience and was recognized as “high performing” for colon cancer surgery, heart failure and hip replacement. Like Crouse, St. Elizabeth Medical Center in Utica received two out of five stars for patient experience and was recognized as “high performing” for chronic obstructive pulmonary disease (COPD), heart failure, hip replacement and knee replacement. Upstate University Hospital in Syracuse, Oswego Health in Oswego, Auburn Community Hospital in Auburn, and Oneida Healthcare in Oneida were not ranked. Upstate received 3 out of 5 stars for patient experience and was recognized as “High Performing” for Chronic Obstructive Pulmonary Disease (COPD) and heart failure. Oswego also got 3 out of 5 starts for patient experience, but was not recognized as “High Performing” for any procedures or conditions. Auburn got 1 out of 5 starts for patient experience and was recognized as “High Performing” for heart failure. And Oneida got 4 out of 5 stars for patient experience, but was not recognized as “High Performing” for any procedures or conditions.U.S. News & World Report says it releases the annual rankings to help patients find sources of especially skilled inpatient care. have different healthcare needs,” she said. “Our students need to become aware of these needs to better serve the patient.” McMullen said an initial area of focus for the program and its scholarships will be rural areas to the north of Syracuse, which consist of populations in need of more primary care providers. The grant will focus on recruiting nurse practitioner students from Oswego County as these students will be more likely to continue working in this setting after graduation, she said. This program will improve access to primary care by recruiting more nurse practitioner students to this rural area. The grant will also establish a primary care clinic in the vicinity of Upstate’s downtown campus for the underserved population in Syracuse, McMullen said. This will be a nurse practitioner-led clinic and offer additional opportunity for student primary care clinical placements locally, she said.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 23

Loretto Launches Telehealth for PACE Program Participants

System monitors EKG, respiratory rate, oxygen levels, skin temperature, heart rate and it can also detect falls


oretto’s Program of All-inclusive Care for the Elderly in Central New York (PACE-CNY) is now offering participants access to a doctor or nurse 24 hours a day, seven days a week, 365 days a year through ImagineMic, a new telehealth program. There is no additional fee for PACE-CNY participants to use this technology. Individuals are equipped with an FDA-approved disposable patch, which is placed on their chest and streams real-time data to a Monitoring Intervention Center (MIC) — a location staffed with physicians and nurses. It monitors EKG, respiratory rate, oxygen levels, skin temperature, heart rate, and it can also detect falls. The network analyzes the data received in real-time to provide predictive insight to help clinicians develop a treatment plan. If immediate attention is necessary when participants are not at a PACE Center, they have mobile access to a virtual audio/ visual consultation with a doctor or nurse using either an iPhone, iPad or Android device.

Peace of Mind

“The addition of ImagineMIC, a device with real-time health monitoring and 24/7 access to a physician, can be a home-based solution for many. This enhanced level of oversight keeps PACE participants in optimal wellness while they are away from the PACE Centers,” said Stephanie Button, vice president of PACECNY. “It also gives family, friends, and caregivers peace of mind and minimizes hospital and emergency room visits, as some health issues can

Photos show a PACE-CNY participant using the new ImagineMIC telehealth technology at Loretto’s PACE-CNY. The system allows for medical professionals — from a remote location — to monitor EKG, respiratory rate, oxygen levels, skin temperature, heart rate of participants. be identified and treated through the telehealth system.” As of July 15, Loretto had 19 PACE-CNY participants enrolled in the ImagineMIC program and using the equipment in their homes, with 17 more signed up to begin. “Joining the PACE-CNY team has been one of the best professional decisions of my career,” said Suzanne M Lamanna, a community physician for PACE-CNY. “As a primary care physician, one of my practice goals is to help my patients stay at home through their ‘senior years’ — The comprehensive care from Loretto and PACE-CNY helps achieve that goal by ensuring the medical, social

and spiritual needs are met for each participant.”

Work With Your Own Caregiver

PACE-CNY offers home care and community services, activities at center locations, and transportation to PACE-CNY activities, outside doctor appointments and other activities. PACE-CNY also works with Medicaid’s Consumer Directed Personal Assistance Program (CDPAP), which allows consumers to recruit, hire, train, supervise, terminate and direct their own home care workers (including family, friends or neighbors). A PACE participant may have

personal assistants from the CDPAP, PACE-CNY home health aides, or a combination of both completing the tasks needed for a comprehensive care plan. If you or a loved one are interested in the PACE-CNY Program, visit www.pacecny.org or call 315452-5800.

New Technology at Loretto to Reduce Cardiac Hospital Readmissions


oretto has implemented a new advanced technology for cardiac patients in its TeliStat Restorative Care Unit (RCU).

The ReDS lung fluid management system enables registered nurses to monitor fluid levels noninvasively.

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

Loretto is the first and only provider in Central New York to offer this cutting-edge technology. The facts: • Many of the signs of cardiac stress rely on the human eye and appear when the condition has already elevated to a medical emergency. • The ReDS lung fluid measurement system is a non-invasive way to identify issues faster than the human eye to mitigate potential risks and get interventions in place before it develops into a medical emergency. • Residents wear a vest with a miniature radar system that employs low-power electromagnetic energy to measure lung fluid in approximately 90 seconds. “Heart failure is one of the main reasons our residents are readmitted to hospitals,” said Joelle Margrey, vice president of clinical skilled nursing at Loretto. “The ReDS system is especially helpful for patients with congestive heart failure, a condition in which fluid increases in the area

surrounding the heart and causes it to pump inefficiently.” Patients with shortness of breath can also benefit from the use of this technology, to see if a build-up of fluid is causing their symptoms. Loretto works closely with St. Joseph’s Health, Crouse Hospital and Upstate University Hospital to maximize the effectiveness of its RCU and reduce hospital readmissions. The 25-bed Telistat RCU opened at the Loretto Health and Rehabilitation Center in Syracuse last spring. The unit uses innovative technology to monitor multiple health risks in real-time via portable monitors and gives cardiac patients the opportunity to complete rehab at a lower cost with a lower risk of rehospitalization. Patients benefit from a patient-to-RN ratio of six-to-one, with additional support coming from certified nursing assistantss. The TRCU at Loretto is the only unit of its kind in Central New York.

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By Jim Miller

Is Pet Insurance a Good Idea for Seniors on a Budget?

Dear Savvy Senior,

I own two dogs and a cat that I would do almost anything for, but expensive veterinary bills put a strain on my budget. Is pet insurance a good idea?

Older Pet Owner

Dear Pet Owner, If you’re the kind of pet owner who would do anything for their furry family, including spending thousands of dollars on medical care, pet insurance definitely is an option to consider. Here’s what you should know. Rising Vet Costs The cost of owning a pet has gone up in recent years. New technologies now make it possible for pets to undergo sophisticated medical treatments for many lifethreatening diseases, just like humans. But these treatments don’t come cheap. That’s why pet insurance has gotten more popular in recent years. More than 2 million pets are currently insured in the U.S. and Canada, according to the North American Pet Health Insurance Association. How Pet Plans Works Pet insurance is actually very similar to human health insurance. Pet policies typically come with premiums, deductibles, co-payments and caps that limit how much will be paid out annually. But unlike people coverage, you usually have to pay the vet bills in full and wait for reimbursement from the insurer. Pet policies vary greatly from basic plans that cover only accidents and illness, to comprehensive policies that provide complete noseto-tail protection including annual checkups and vaccinations, spaying or neutering and death benefits. You should also be aware that pet policies typically don’t cover preexisting conditions, and premiums are generally lower when your pet is young and healthy. Costs for pet insurance will also vary by insurer and policy, but premiums typically depend on factors like the cost of veterinary care where you live and the age and breed of the pet. The average annual premium for basic accident and illness coverage was $516 per pet in 2017, while the average claim paid was $278, according to the pet health insurance association. Shopping Tips Major pet policy providers

include the ASPCA, Embrace, Healthy Paws, Nationwide, PetFirst, Petplan and Trupanion. To help you shop and compare coverage and costs from pet insurers, go to PetInsuranceReview.com. If you’re still working, one way to pay lower premiums, and possibly get broader coverage, is to buy pet insurance through your employer, if available. Eleven percent of employers in the U.S. offer pet health insurance benefits, according to the Society for Human Resource Management, and these plans are usually discounted. Alternative Option Many animal advocates think most pet owners are better off forgoing pet insurance and instead putting the money you would have spent on premiums into a dedicated savings account to pay for vet care as needed. Depending on the policy, pet insurance can cost $1,500 to $6,000 over the life of an average pet, and most pet owners will never spend that much for treatment. Ways to Save If you can’t afford pet insurance or choose not to buy it, there are other ways you can save. For example, many local animal shelters offer free or low-cost spaying and neutering programs and vaccinations, and some shelters work with local vets who are willing to provide care at reduced prices for low-income and senior pet owners. There are also a number of organizations that provide financial assistance to pet owners in need. To locate these programs, visit HumaneSociety.org/PetFinancialAid. To save on pet medications, get a prescription from your vet (ask for generic is possible) so you can shop for the best price. Medicine purchased at the vet’s office is usually more expensive than you can get from a regular pharmacy or online. Most pharmacies fill prescriptions for pets inexpensively, and many pharmacies offer pet discount savings programs too. You can also save by shopping online at a verified pharmacy like 1800PetMeds. com, DrsFosterSmith.com and PetCareRX.com.

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

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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‘Choosing Your Own Caregiver’

Program allows consumers to recruit, hire, train or terminate their own home care workers


aking care of an elderly family member can demand a lot of time, and it can be especially difficult if you are also taking care of children and working. Medicaid’s Consumer Directed Personal Assistance Program (CDPAP) offers an innovative way to care for a loved one and ensure they are receiving the best care that they needed. CDPAP allows consumers to recruit, hire, train, supervise, terminate and direct their own home care workers — including family, friends or neighbors. Iesha Darby is a local CDPAP personal assistant and provides care for her grandmother at home. Before joining CDPAP, Darby was taking care of her children, her grandmother and working three jobs. But she recently learned that Loretto’s PACE CNY offers an option for Darby to be paid to be her grandmother’s caregiver, and for her grandmother to also receive support services from PACE. “I am very thankful for the help from PACE in guiding me through

the Medicaid application process and making the transition much easier,” she said. “Now I can provide the best care for my grandmother, and I am less worried about her quality of care and managing everything else in my life.” Darby was so happy to have this opportunity to continue providing care for her grandmother. She loves being able to take time off and have other family members cover for her, and having PACE CNY transportation available to take her grandmother to appointments without a hassle. But most importantly, she loves knowing that her grandmother is able to stay home and out of a nursing home, receiving the proper care that she needs. Darby said: “With CDPAP and PACE CNY, you are able to provide the best care for your loved one with comfort, love and less worry.” To learn more about CDPAP and how to become a personal assistant please visit www.pacecny.org or call 315-452-5800. Submitted by Loretto


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Changing Your Direct Deposit Information with Social Security


ith our busy lives, it’s easy to fall into that cycle of postponing some tasks because of other priorities. This may be true for you when it comes to changing your payment method for Social Security benefits. Unfortunately, forgetting to change your payment method can lead to delayed payments. The most convenient way to change your direct deposit information with Social Security is by creating a my Social Security account online at www.socialsecurity.gov/ myaccount. Once you create your account, you can update your bank information without leaving the comfort of your home. Another way to change your direct deposit is by calling Social Security at 1-800-772-1213 (TTY 1-800-325-0778) to make the change over the phone. If you prefer to speak to someone in person, you can visit your local Social Security office with the necessary information. Because we are committed to protecting your personal information, we need some form of identification to verify who you are. If you are online, we verified your identity when you initially created your my Social Security account. All you need to do is log in at www.socialsecurity. gov/myaccount with your secure username and password to gain access


Q: I am very happy that I was just approved to receive disability benefits. How long will it be before I get my first payment? A: If you’re eligible for Social Security disability benefits, there is a five-month waiting period before your benefits begin. We’ll pay your first benefit for the sixth full month

to your information. If you call Social Security, we will ask identifying questions to ensure we are speaking to the right person. If you visit the office, you will need to bring a driver’s license or some form of ID with you. Once we have identified that you are the correct person and are authorized to make changes on the Social Security record, all we need is the routing number, account number, and type of account established. We don’t ask for a voided check, nor do we obtain verification from the bank. Therefore, you should be sure you are providing accurate information to us. Because you may be unsure if your direct deposit change will affect your next payment, we highly recommend that you do not close the old bank account until you have seen your first Social Security deposit in the new bank account. That way, you can feel secure you will receive your benefits on time, regardless of when the change was reported to Social Security. When you have to report changes to your direct deposit, be sure to visit us online at www.socialsecurity. gov/myaccount. Social Security always strives to put you in control by providing the best experience and service no matter where, when, or how you decide to do business with us.

after the date we find your disability began. For example, if your disability began on June 15, your first benefit would be paid for the month of December, the sixth full month of disability, and you would receive your first benefit payment in January 2020. You can read more about the disability benefits approval process at www.socialsecurity.gov/planners/ disability/dapproval.html.

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

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Americans’ Prescription Med Use Is Declining


ucking a longstanding upward trend, new data shows that the percentage of Americans taking any prescription drug has fallen slightly over the past decade. Still, nearly half — 45.8% — of Americans said they took at least one prescription medicine over the past month, according to a national survey conducted in 2015-2016. That’s a slight dip from the 48.3% of Americans — children and adults — who reported taking a prescribed drug in the same survey conducted in 2007-2008, according to a team from the U.S. Centers for Disease Control and Prevention’s National

Center for Health Statistics (NCHS). The drop in prescription use reverses a trend that had persisted since the 1990s, the study authors said. It’s not clear why fewer Americans are taking prescription meds now than a decade before, although the researchers cite a possible “decline in the use of inappropriate or ineffective therapies.” The new statistics showed that males were less likely to be taking prescription meds than females (41.5% vs. 50%, respectively). But the gender divide varied greatly, depending on age group.

Serving Onondaga, Cayuga, Oswego & Madison Counties

For example, among children under the age of 12, boys (22%) were more likely to take a prescription drug than girls (nearly 14%), a trend driven largely by use of drugs for attention-deficit/hyperactivity disorder (ADHD). But by the time people reached adulthood (ages 20 to 59), women were more likely to outpace men in prescription drug use, at 55.5% and 37.5%, respectively. Drug use trends tended to “illustrate differences in the prevalence of health conditions at various stages of life,” according to the NCHS team, which was led by Crescent Martin. In childhood, meds used to treat asthma or ADHD were by far

the most common, while antidepressants were most often prescribed for people in their 20s through 50s, the findings showed. However, by the time people reached the age of 60 and above, cholesterol meds (such as statins) were the most prescribed, with nearly half of Americans in this age category taking such drugs. About one-quarter of people aged 60 or older were also prescribed medicines to curb their high blood pressure, while nearly 23% used a diabetes drug, the researchers found. The new report was published May 8 as an NCHS Data Brief.

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H ealth News St. Joe’s has new chief of medical affairs Physician Cristian Andrade has been appointed St. Joseph’s Health’s new vice president of medical affairs (VPMA). In this role, he will oversee medical staff and leadership obligations to each other and responsibilities to patients, ensuring the highest levels of quality care. He will also support St. Joseph’s culture of close and mutually beneficial relationships between the medical staff and leadership. Andrade has been with St. Joseph’s for 16 years. Family medicine-trained, he joined St. Joseph’s as a resident in 2003 and he has served as a St. Joseph’s hospitalist since 2006. During that time, Andrade has assumed progressive administrative responsibilities, most recently as the regional medical director and chief of hospitalist services. In 2019, he completed the advanced executive leadership for physicians training at Cornell University. As VPMA, Andrade will provide administrative oversight for multiple programs and areas, including medical staff governance, utilization review and the hospitalist service. He will also focus on improving length of stay, a priority strategic aim for St. Joseph’s Health and Trinity Health, and will be instrumental in strategic planning for long-term success.

Two new physicians join Crouse Health Crouse Helath recently announced two new physicians have joined its staff. • Viren Kaul, board-certified in pulmonology and critical care medicine, will see new patients at Crouse Medical Practice, 739 Irving Ave., suite 200 in Syracuse, where he will provide care for those with conditions including Kaul chronic obstructive pulmonary disease (COPD), asthma, bronchitis, emphysema, pneumonia, pulmonary fibrosis and sarcoidosis. He will also serve as a member of the critical care medicine team at Crouse Hospital. Kaul earned his medical degree at Karnataka Institute of Medical Sciences in his native India. He completed his residency in internal medicine at SUNY Upstate Medical University and served as chief resident in internal medicine at Lahey Hospital and Medical Center in Burlington, outside Boston. He then went on to complete a fellowship and serve as a chief fellow in pulmonary and critical care medicine at the Icahn Mount Sinai School of Medicine, in its Elmhurst Hospital Center, located in Queens. Kaul is a member of the American College of Physicians, American College of Chest Physicians and the American Thoracic Society. Additionally, he is widely published, with a Page 28

particular clinical interest in the applications of technology in medical education and the clinical setting. He is fluent in Hindi and Kashmiri, with a proficiency in Punjabi. • Paraskos Araouzos, board certified in family medicine, will see new patients at Crouse Medical Practice, located at 4500 Pewter Lane, building 1, in Manlius. Araouzos — known to his patients as “Dr. Perry” — earned his medical degree at Upstate Medical Araouzos University and his bachelor’s degree in biomedical education at City University of New York. He completed his residency in family medicine at St. Joseph’s Hospital Health Center, and has been a primary care physician in Central New York for many years. A native of the Bronx, Araouzos is a member of the American Medical Society and the American Academy of Family Physicians.

BRiDGES Tobacco Prevention has new coordinator BRiDGES Tobacco Prevention Reality Check program welcomes Kali Bushey as its new reality check lead coordinator. She brings her experience as a former reality check youth leader and replaces Heather Bernet, who advanced to the position of advancing tobacco-free communities statewide coordinator. For the last 10 years, the BRiDGES Tobacco-Free Program of Madison, Oneida and Herkimer Counties has worked with community leaders and youth champions to help reduce tobacco use in all three counties. The organization launched its next five-year contract with a new reality check lead coordinator and the additional position of statewide coordinator. The contract is through the New York State Department of Health, Bureau of Tobacco Control. BRiDGES tobacco-free program supports efforts to locally educate community stakeholders and youth in changing norms that lead to ending tobacco use among adults and children.

Crouse investing $2.5 million in pediatric cardiac catheterization Crouse Health has started work on a $2.5 million renovation and upgrade of its 700-sq.-ft. pediatric cardiac catheterization suite, located in the hospital’s Diane and Bob Miron Cardiac Care Center. Work on the upgrade is expected to be completed by the end of November, according to physician Joseph Battaglia, chief of cardiology at Crouse. The current pediatric catheterization lab was constructed in 1999 and is nearing the end of its

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

St. Luke’s Gretchen Rebeor Recognized with ‘Employee of Distinction Award’


t. Luke Health Services Certified Nursing Assistant Gretchen Rebeor is the recipient of a 2019 Long Term Care Employee of Distinction Award. Rebeor received the award during a ceremony held recently in her honor at St. Luke. The statewide award presented by LeadingAge NY, an association representing mission–driven, nonprofit continuing care providers, recognized Rebeor’s outstanding commitment and professionalism over her 21 year career with the local healthcare provider. “This recognition is well earned and we are fortunate to have Gretchen, and pleased to share this statewide recognition celebrating her achievements,” said St. Luke

CEO and Administrator Terrence Gorman. “A common theme often repeated when describing Gretchen is her willingness to go beyond what is expected, and to make everyday a better day for our residents and her fellow caregivers.” Pictured presenting the award is (from left) Jim Thomas, representing NYS Sen. Patty Ritchie; NYS Assemblyman William Barclay; award winner Gretchen Rebeor; Terrence Gorman, St. Luke CEO and Administrator; and James W. Clyne, President and CEO of LeadingAge NY. Rebeor received a resolution by the New York State Legislature honoring her and other award recipients from across the state.

useful life. It will be replaced by a new, next-generation Phillips cardiac biplane system, which features an image-guided platform designed to provide high-resolution imaging over a large field of view for interventional cardiology, pediatric cardiology and electrophysiology procedures. The project also calls for all new LED lighting and an increase in square footage in the procedure room to help expand circulation and maneuvering in the room. Crouse is home to the region’s only pediatric catheterization program, a partnership with Syracuse-based Pediatric Cardiology Associates that provides life-saving cardiac care to more than 150 infants, young children and teens annually. In addition to the pediatric cath suite, the Miron Cardiac Care Center features two adult cath labs and an adult electrophysiology lab. Between the four procedure rooms, Crouse performs more than 2,500 interventional and diagnostic cardiac procedures annually.

cover a total of 1,919 square miles. Home care services are seriously lacking in the rural region, leaving patients underserved, according to a St. Joseph’s news release. St. Joseph’s Health Home Care’s expansion will extend service from the hospital, clinics and physician offices to the home setting, allowing for a safe transition home following a procedure or illness. “There is an ever-increasing demand for quality homecare services that allow people to recover in the comfort of their own home and prevent re-hospitalizations,” said Michelle Eymer, director of patient services for St. Joseph’s Health Home Care. “Our staff is committed to promoting health, managing disease and providing compassionate care to all the patients we serve.” St. Joseph’s Health Home Care sets the standard for highly skilled care by providing an array of services including skilled nursing, psychiatric nursing, rehabilitation, social work and home health aides. With this expansion, St. Joseph’s will increase job opportunities in the community. The interview process has already begun for nurses and once they’re hired, recruiting will begin for other disciplines. The number of jobs will grow as patient numbers grow. “We are looking for devoted, high-caliber employees who want to use their clinical expertise to improve the quality of life for patients,” Eymer said. “Our goal is to allow patients to reach their optimum level of health and function.”

St. Joe’s home care to expand in Madison, Oneida St. Joseph’s Health Home Care, a leading force in home health, is expanding into Oneida and Madison counties, bringing much-needed quality home care services to residents in those areas. Oneida and Madison counties

Neurosurgeon joins Crouse Medical Practice Neurosciences


oard-certified and fellowship-trained cerebrovascular and endovascular neurosurgeon Jorge Eller has joined Crouse Health. He will see new patients at Crouse Medical Practice Neurosciences, 739 Irving Ave. Eller comes to Crouse from his most recent position at the AtlantiCare Neurosciences Institute and the faculty at Thomas Jefferson University at AtlantiCare Regional Medical Center in Atlantic City, New Jersey. After earnEller ing his medical degree from the Universidade Federal do Espirito Santo Medical School in his native Brazil in 1995, Eller completed an internship in general surgery and a residency in neurological surgery at SUNY Upstate Medical University. During his residency, he pursued research in the treatment of malignant brain tumors using monoclonal antibodies against the tumor tissue. Eller completed a fellowship in stereotactic and functional neurosurgery at Oregon Health and Science University in Portland, Oregon. He then served as an assistant professor of neurological surgery at Oregon Health and Science University and as chief of neurosurgery at the Portland VA Medical Center. In 2010, he joined the faculty of Saint Louis University, where he completed a fellowship in cerebrovascular and skull base surgery. This specialized training was followed by a fellowship in endovascular neurosurgery at the State University of New York at Buffalo. Eller has published and lectured on surgery for brain tumors, movement disorders, trigeminal neuralgia, skull base approaches and surgical and endovascular management of cerebrovascular disease throughout his career. His more recent research and clinical activities have included innovative surgical approaches and minimally invasive endovascular techniques to treat a broad spectrum of neurosurgical diseases. Eller’s clinical interests focus primarily on complementary microsurgical and endovascular approaches for the management of cerebrovascular diseases, including acute strokes, intracranial aneurysms, carotid stenosis, intracranial stenosis, arteriovenous malformations, arteriovenous fistulas, spinal fistulas, cavernous malformations, epistaxis and intracerebral hemorrhages. His broad training and expertise also include microsurgical management of brain tumors, skull base tumors, acoustic neuromas, pituitary tumors, meningiomas, hemifacial spasm, and trigeminal neuralgia. Certified by the American Board of Neurological Surgery, Eller is a member of the American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS).

Find Us on facebook @ In Good Health Central New York September 2019 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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

he United States has grown a bumper crop of couch potatoes in recent years, a new study reports. The amount of time people spend sitting around actually increased after the initial release of the federal Physical Activity Guidelines for Americans in 2008, researchers have found. “Over the past 10 years, there was no significant change in physical activity levels, but there was a significant increase in the time we sit around,” said senior researcher Wei Bao. He’s an assistant professor of epidemiology at the University of Iowa in Iowa City. As a result, the proportion of people who didn’t get enough aerobic exercise and also sat around for more than six hours a day rose from 16% to nearly 19% between 2007 and 2016, according to the study published online July 26 in JAMA Network Open. An inactive lifestyle has been linked to many chronic diseases. Sitting around too much increases your risk of obesity, heart disease, high blood pressure, stroke, high cholesterol, Type 2 diabetes, osteoporosis, depression, anxiety and even certain cancers, according to the U.S. Department of Health and Human Services. Because of this, federal health officials released the activity guidelines, which recommend adults get at least 150 minutes a week of moderate-intensity exercise or 75 minutes a week of vigorous-intensity exercise. Moderate-intensity activity can include mowing the lawn, playing tennis, enjoying a leisurely bike ride, engaging in a brisk walk, or doing heavy housework like vacuuming, mopping or washing windows. Vigorous exercise includes jogging, bicycling fast, playing basketball or soccer, shoveling dirt or carrying heavy loads. To see how many Americans meet these recommendations, Bao’s team reviewed data from a series of federal studies that track health trends among U.S. adults and children. The investigators found that time

The proportion of people who didn’t get enough aerobic exercise and also sat around for more than six hours a day has increased.

spent sitting increased from 5.7 hours a day in 2007-2008 to 6.4 hours a day in 2015-2016. The increase in sedentary behavior was seen in nearly every major subgroup of the U.S. population, the study authors said. At the same time, there was no real change in Americans’ physical activity. About 65% of people met guidelines for aerobic activity in 2015-2016, compared with 63% in 2007-2008, the study found. American life is designed to be cushy, so it’s natural that folks settle in and relax rather than get up and go, Bao said. “This will be a natural phenomenon for a convenience society, for a modern society like the United States,” he said. “I think sitting down is a natural desire for humans. When people are tired at work and go home, the first thing is to lie down on the sofa and watch TV for another two hours.” American jobs have also gotten less physically demanding, said Donna Arnett, dean of the University of Kentucky College of Public Health, in Lexington. “If you look at physical activity from occupational energy expenditure, that has been going down dramatically over the past three to four decades,” she said. “Our jobs are getting more automated. There’s much less physical activity at work.” The proliferation of screens at work and home hasn’t helped, she added. “The automation in our lives at home and at work — is also likely related to the increased use of screen time. People are spending more time looking at their phones and working on their computers, even after hours,” Arnett said.



Upstate is pleased to announce the addition of new physicians and office locations. Our united expertise brings you advanced technology and streamlined care. As part of the Upstate Heart Institute, we provide connections to research and surgical care.



Dana C. Aiello, MD Larry S. Charlamb, MD Mark J. Charlamb, MD Christopher A. Nardone, MD Matthew S. O’Hern, MD Charles Perla, MD Theresa Waters, DO Andrew M. Weinberg, DO

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


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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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

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